Provider Demographics
NPI:1346892353
Name:THOMPSON, JANA ELIZABETH (982-11-1-18 LPC ND)
Entity Type:Individual
Prefix:
First Name:JANA
Middle Name:ELIZABETH
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:982-11-1-18 LPC ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5200 KELLER SPRINGS RD APT 417
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75248-2741
Mailing Address - Country:US
Mailing Address - Phone:701-305-0913
Mailing Address - Fax:
Practice Address - Street 1:5200 KELLER SPRINGS RD APT 417
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75248-2741
Practice Address - Country:US
Practice Address - Phone:701-305-0913
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-10
Last Update Date:2023-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND982-11-1-18A101Y00000X
ND982-11-1-18101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty