Individual
CHARLES THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LICSW
Contact information
Practice address
2364 WASHINGTON ST, NEWTON, MA 02462-1440
(617) 332-2047
(617) 332-7341
Mailing address
2364 WASHINGTON ST, NEWTON, MA 02462-1440
(617) 332-2047
(617) 332-7341
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
106123
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P07427
BLUE CROSS BLUE SHIELD
MA
Enumeration date
01/25/2006
Last updated
04/23/2008
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