Provider Demographics
NPI:1326429424
Name:THOMPSON, TAMMY (LCMHC, MLADC, LPC)
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:LCMHC, MLADC, LPC
Other - Prefix:
Other - First Name:TAMMY
Other - Middle Name:
Other - Last Name:THOMPSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS
Mailing Address - Street 1:401 CYPRESS ST
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03103-3699
Mailing Address - Country:US
Mailing Address - Phone:603-668-4111
Mailing Address - Fax:
Practice Address - Street 1:401 CYPRESS ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03103
Practice Address - Country:US
Practice Address - Phone:603-668-4111
Practice Address - Fax:603-628-7757
Is Sole Proprietor?:No
Enumeration Date:2015-06-15
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1035101YA0400X
FLTPMC1918101YM0800X
UT12972851-6004101YM0800X, 101YP2500X
VA0701012427101YP2500X
NH2315101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional