Provider Demographics
NPI:1609994466
Name:THOMPSON, CAROL ELISE (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:ELISE
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7099 COUNTY ROAD 206
Mailing Address - Street 2:
Mailing Address - City:CELINA
Mailing Address - State:TX
Mailing Address - Zip Code:75009-4959
Mailing Address - Country:US
Mailing Address - Phone:972-679-2167
Mailing Address - Fax:
Practice Address - Street 1:1506 N GREENVILLE AVE
Practice Address - Street 2:SUITE 250
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75002-8622
Practice Address - Country:US
Practice Address - Phone:972-679-2167
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX200800106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX200800OtherMFT LICENSURE NUMBER