Provider Demographics
NPI:1689953408
Name:THOMPSON, KATHRYN ELIZABETH (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:ELIZABETH
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 1:1019 POYNTZ AVE
Mailing Address - Street 2:STE C
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66502-6760
Mailing Address - Country:US
Mailing Address - Phone:785-539-5455
Mailing Address - Fax:785-776-7570
Practice Address - Street 1:1019 POYNTZ AVE
Practice Address - Street 2:SUITE C
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502-6760
Practice Address - Country:US
Practice Address - Phone:785-539-5455
Practice Address - Fax:785-776-7570
Is Sole Proprietor?:No
Enumeration Date:2011-08-10
Last Update Date:2013-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2343106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200735280AMedicaid