Provider Demographics
NPI:1629182274
Name:THOMPSON, MONIQUE MICHELLE (LPC)
Entity Type:Individual
Prefix:
First Name:MONIQUE
Middle Name:MICHELLE
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4100 MCEWEN RD
Mailing Address - Street 2:SUITE 285
Mailing Address - City:FARMERS BRANCH
Mailing Address - State:TX
Mailing Address - Zip Code:75244-5113
Mailing Address - Country:US
Mailing Address - Phone:972-820-9965
Mailing Address - Fax:866-278-4727
Practice Address - Street 1:4100 MCEWEN RD
Practice Address - Street 2:SUITE 285
Practice Address - City:FARMERS BRANCH
Practice Address - State:TX
Practice Address - Zip Code:75244-5113
Practice Address - Country:US
Practice Address - Phone:972-820-9965
Practice Address - Fax:866-278-4727
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17013101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health