Provider Demographics
NPI:1093313272
Name:THOMPSON, SCARLETT AMBER-LYNN (LMHC)
Entity Type:Individual
Prefix:
First Name:SCARLETT
Middle Name:AMBER-LYNN
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 1:913 HINKLE ST
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:NM
Mailing Address - Zip Code:88101-5846
Mailing Address - Country:US
Mailing Address - Phone:575-693-6609
Mailing Address - Fax:
Practice Address - Street 1:913 HINKLE ST
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:NM
Practice Address - Zip Code:88101-5846
Practice Address - Country:US
Practice Address - Phone:575-693-6609
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-11
Last Update Date:2020-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMT-CTL0212751101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor