Provider Demographics
NPI:1326258393
Name:THOMPSON, CRISSY ANN (PLPC)
Entity Type:Individual
Prefix:MRS
First Name:CRISSY
Middle Name:ANN
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:AR
Mailing Address - Zip Code:72936-7007
Mailing Address - Country:US
Mailing Address - Phone:479-651-1219
Mailing Address - Fax:
Practice Address - Street 1:420 N MAIN ST
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:AR
Practice Address - Zip Code:72936
Practice Address - Country:US
Practice Address - Phone:479-651-1219
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2018-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2007008535101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health