Provider Demographics
NPI:1194183889
Name:THOMPSON, SARA OLIVIA (LAMFT)
Entity Type:Individual
Prefix:MISS
First Name:SARA
Middle Name:OLIVIA
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:LAMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 PEACHFORD RD
Mailing Address - Street 2:UNIT #2211
Mailing Address - City:DUNWOODY
Mailing Address - State:GA
Mailing Address - Zip Code:30338-5820
Mailing Address - Country:US
Mailing Address - Phone:770-454-5677
Mailing Address - Fax:
Practice Address - Street 1:2300 PEACHFORD RD
Practice Address - Street 2:UNIT #2211
Practice Address - City:DUNWOODY
Practice Address - State:GA
Practice Address - Zip Code:30338-5820
Practice Address - Country:US
Practice Address - Phone:770-454-5677
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-09
Last Update Date:2016-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAMFT000353106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist