Provider Demographics
NPI:1477093847
Name:THOMPSON, KRISTI COLLIER (LPCC)
Entity Type:Individual
Prefix:
First Name:KRISTI
Middle Name:COLLIER
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 UPS DR STE 107
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-4046
Mailing Address - Country:US
Mailing Address - Phone:502-339-4511
Mailing Address - Fax:
Practice Address - Street 1:1700 UPS DR STE 107
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40223-4046
Practice Address - Country:US
Practice Address - Phone:502-339-4511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-03
Last Update Date:2017-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39000652A101YM0800X
KY1085101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health