Provider Demographics
NPI:1487660668
Name:THOMSON, ROBERT DOUGLAS (LPCC)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:DOUGLAS
Last Name:THOMSON
Suffix:
Gender:M
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:705 CAMINO DEL BOSQUE NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87114-2307
Mailing Address - Country:US
Mailing Address - Phone:505-898-6476
Mailing Address - Fax:505-898-6476
Practice Address - Street 1:201 TULANE DR SE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87106-1413
Practice Address - Country:US
Practice Address - Phone:505-280-4351
Practice Address - Fax:505-898-6476
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0484101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional