Provider Demographics
NPI:1811870868
Name:THOMPSON, WAYNE ALLEN (LMSW)
Entity type:Individual
Prefix:
First Name:WAYNE
Middle Name:ALLEN
Last Name:THOMPSON
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 UNSER BLVD SE STE 200
Mailing Address - Street 2:
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87124-4660
Mailing Address - Country:US
Mailing Address - Phone:505-448-4870
Mailing Address - Fax:505-531-8023
Practice Address - Street 1:5001 INDIAN SCHOOL RD NE STE 200
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-4082
Practice Address - Country:US
Practice Address - Phone:505-548-9023
Practice Address - Fax:505-531-8023
Is Sole Proprietor?:No
Enumeration Date:2025-07-28
Last Update Date:2025-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMSWB202505391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical