Provider Demographics
NPI:1043889801
Name:BILLOCK-THOMPSON, LAINEY (LPC)
Entity Type:Individual
Prefix:
First Name:LAINEY
Middle Name:
Last Name:BILLOCK-THOMPSON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:532 RAMBOW DR
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:MI
Mailing Address - Zip Code:48161-3549
Mailing Address - Country:US
Mailing Address - Phone:734-430-9395
Mailing Address - Fax:
Practice Address - Street 1:532 RAMBOW DR
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:MI
Practice Address - Zip Code:48161-3549
Practice Address - Country:US
Practice Address - Phone:734-430-9395
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-24
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401223007101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health