Provider Demographics
NPI:1003113614
Name:THOMPSON, NORMAN ANTHONY (MED, LCPC)
Entity Type:Individual
Prefix:MR
First Name:NORMAN
Middle Name:ANTHONY
Last Name:THOMPSON
Suffix:
Gender:M
Credentials:MED, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9619 UTICA PL
Mailing Address - Street 2:
Mailing Address - City:SPRINGDALE
Mailing Address - State:MD
Mailing Address - Zip Code:20774-5449
Mailing Address - Country:US
Mailing Address - Phone:202-341-1862
Mailing Address - Fax:
Practice Address - Street 1:9619 UTICA PL
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:MD
Practice Address - Zip Code:20774-5449
Practice Address - Country:US
Practice Address - Phone:202-341-1862
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-16
Last Update Date:2011-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC2146101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health