Provider Demographics
NPI:1639577042
Name:THOMPSON-HERRIN, LINDA LEE
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:LEE
Last Name:THOMPSON-HERRIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:LEE
Other - Last Name:HERRIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC
Mailing Address - Street 1:350 S MEADE ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80219-2657
Mailing Address - Country:US
Mailing Address - Phone:303-798-2686
Mailing Address - Fax:
Practice Address - Street 1:350 S MEADE ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80219-2657
Practice Address - Country:US
Practice Address - Phone:303-798-2686
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-17
Last Update Date:2014-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO475101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional