Provider Demographics
NPI:1497931612
Name:LONSBERRY-THOMPSON, NANCY (LLP, RPT-S)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:LONSBERRY-THOMPSON
Suffix:
Gender:F
Credentials:LLP, RPT-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 N WEST AVE
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49201-1903
Mailing Address - Country:US
Mailing Address - Phone:517-544-7700
Mailing Address - Fax:517-612-8817
Practice Address - Street 1:202 N WEST AVE
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49201-1903
Practice Address - Country:US
Practice Address - Phone:517-544-7700
Practice Address - Fax:517-612-8817
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-17
Last Update Date:2015-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301007908101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health