Provider Demographics
NPI:1083043772
Name:THOMPSON, CHAUTE (LMHC)
Entity Type:Individual
Prefix:
First Name:CHAUTE
Middle Name:
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10380 SW VILLAGE CENTER DR # 378
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34987-1931
Mailing Address - Country:US
Mailing Address - Phone:772-302-6191
Mailing Address - Fax:772-872-5245
Practice Address - Street 1:601 21ST ST STE 300
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-0860
Practice Address - Country:US
Practice Address - Phone:772-302-6191
Practice Address - Fax:772-872-5245
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-04
Last Update Date:2021-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH14243101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL101YM0800XMedicaid
FL101Y00000XMedicaid