Provider Demographics
NPI:1003087800
Name:THOMPSON, MADELINE (MA LCADC)
Entity Type:Individual
Prefix:
First Name:MADELINE
Middle Name:
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:MA LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:933 ROUTE 23
Mailing Address - Street 2:SUITE #10
Mailing Address - City:POMPTON PLAINS
Mailing Address - State:NJ
Mailing Address - Zip Code:07444-1047
Mailing Address - Country:US
Mailing Address - Phone:973-222-6762
Mailing Address - Fax:
Practice Address - Street 1:544 TERRACE DR
Practice Address - Street 2:
Practice Address - City:HIGHLAND LAKES
Practice Address - State:NJ
Practice Address - Zip Code:07422-1605
Practice Address - Country:US
Practice Address - Phone:973-764-4872
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-19
Last Update Date:2008-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ#37LC00133700101YA0400X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)