Provider Demographics
NPI:1235153107
Name:THOMPSON, DEBRA KAY (LPC-MH, QMHP)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:KAY
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:LPC-MH, QMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2121 W 63RD PL
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57108-5058
Mailing Address - Country:US
Mailing Address - Phone:605-331-6359
Mailing Address - Fax:
Practice Address - Street 1:2121 W 63RD PL
Practice Address - Street 2:SUITE 100
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57108-5058
Practice Address - Country:US
Practice Address - Phone:605-373-9330
Practice Address - Fax:605-373-9210
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDMH2123101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD6171OtherAVERA HEALTH PLAN
SD4994221OtherWELLMARK
SD9209484OtherDAKOTA CARE
SD23442OtherSIOUX VALLEY HEALTH PLAN