Provider Demographics
NPI:1598810962
Name:THOMPSON, PAUL EDWARD (MS, LPC)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:EDWARD
Last Name:THOMPSON
Suffix:
Gender:M
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5751 KROGER DR.
Mailing Address - Street 2:STE. 269
Mailing Address - City:KELLER
Mailing Address - State:TX
Mailing Address - Zip Code:76244-5651
Mailing Address - Country:US
Mailing Address - Phone:817-812-2880
Mailing Address - Fax:817-812-3096
Practice Address - Street 1:5751 KROGER DR.
Practice Address - Street 2:STE. 269
Practice Address - City:KELLER
Practice Address - State:TX
Practice Address - Zip Code:76244-5651
Practice Address - Country:US
Practice Address - Phone:817-812-2880
Practice Address - Fax:817-812-3096
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2013-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11488101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX5360LCOtherBLUE CROSS & BLUE SHIELD
TX101407614OtherUNITED BEHAVIORAL HEALTH
TX4345207OtherAETNA PROVIDER NUMBER