Provider Demographics
NPI:1093034597
Name:THOMPSON, STEPHEN DUANE JR (LPC)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:DUANE
Last Name:THOMPSON
Suffix:JR
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6322 PUMPERNICKEL LN
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NC
Mailing Address - Zip Code:28110-9699
Mailing Address - Country:US
Mailing Address - Phone:704-282-0973
Mailing Address - Fax:
Practice Address - Street 1:6322 PUMPERNICKEL LN
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NC
Practice Address - Zip Code:28110-9699
Practice Address - Country:US
Practice Address - Phone:704-282-0973
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-24
Last Update Date:2010-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7457101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional