Provider Demographics
NPI:1578745758
Name:THOMPSON, LINDA KAY (PHD)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:KAY
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 GREENWAY CIR
Mailing Address - Street 2:
Mailing Address - City:FAIRLESS HILLS
Mailing Address - State:PA
Mailing Address - Zip Code:19030-4013
Mailing Address - Country:US
Mailing Address - Phone:573-999-5463
Mailing Address - Fax:
Practice Address - Street 1:10360 DRUMMOND RD
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19154-3815
Practice Address - Country:US
Practice Address - Phone:215-612-3218
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-29
Last Update Date:2017-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOCS001125101YP2500X
PAPC007008101YP2500X
PAMFA000870106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA600882815OtherMAGELLAN