Provider Demographics
NPI:1588552731
Name:THOMPSON, JENNIFER LAUREN
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LAUREN
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8221 HIDDEN VALLEY CT
Mailing Address - Street 2:
Mailing Address - City:AMELIA COURT HOUSE
Mailing Address - State:VA
Mailing Address - Zip Code:23002-3875
Mailing Address - Country:US
Mailing Address - Phone:703-407-6138
Mailing Address - Fax:
Practice Address - Street 1:330 CORBETT HALL
Practice Address - Street 2:
Practice Address - City:ORONO
Practice Address - State:ME
Practice Address - Zip Code:04469-0001
Practice Address - Country:US
Practice Address - Phone:207-581-2034
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-26
Last Update Date:2025-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist