Provider Demographics
NPI:1407057532
Name:THOMPSON, THOMAS STEPHEN (PHD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:STEPHEN
Last Name:THOMPSON
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4236 FOREST AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45212-3350
Mailing Address - Country:US
Mailing Address - Phone:513-531-6633
Mailing Address - Fax:
Practice Address - Street 1:7800 COOPER RD STE 101A
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45242-7733
Practice Address - Country:US
Practice Address - Phone:513-489-1171
Practice Address - Fax:513-489-6036
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4150103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist