Individual
BRIAN K THOMPSON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
6916 S PAXTON AVE, CHICAGO, IL 60649-1718
(773) 757-3338
Mailing address
6916 S PAXTON AVE, CHICAGO, IL 60649-1718
(773) 757-3338
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149.019208
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1831302959
—
IL
Enumeration date
08/04/2017
Last updated
07/21/2022
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