Provider Demographics
NPI:1164704300
Name:THOMPSON, JERRIE LYNN (LPC)
Entity Type:Individual
Prefix:MRS
First Name:JERRIE
Middle Name:LYNN
Last Name: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 1:252 W SWAMP RD
Mailing Address - Street 2:UNIT 36
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18901-2422
Mailing Address - Country:US
Mailing Address - Phone:215-534-0152
Mailing Address - Fax:866-561-7548
Practice Address - Street 1:252 W SWAMP RD
Practice Address - Street 2:UNIT 36
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901-2422
Practice Address - Country:US
Practice Address - Phone:215-534-0152
Practice Address - Fax:866-561-7548
Is Sole Proprietor?:No
Enumeration Date:2011-09-14
Last Update Date:2013-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC002851101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPC002851OtherPA BOARD OF SOCIAL WORK