Provider Demographics
NPI:1407986177
Name:THOMPSON, BETTY GREEN (MA LPC LMFT RPT S)
Entity Type:Individual
Prefix:MS
First Name:BETTY
Middle Name:GREEN
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:MA LPC LMFT RPT S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4525 LEMMON AVE
Mailing Address - Street 2:STE 200
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75219
Mailing Address - Country:US
Mailing Address - Phone:214-526-4525
Mailing Address - Fax:214-520-6468
Practice Address - Street 1:4525 LEMMON AVE
Practice Address - Street 2:STE 200
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75219
Practice Address - Country:US
Practice Address - Phone:214-526-4525
Practice Address - Fax:214-520-6468
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1303101YP2500X
TX497106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist