Provider Demographics
NPI:1720564297
Name:THOMPSON, DONNA M (LPC)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:M
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:600 COASTAL VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:GA
Mailing Address - Zip Code:31520-1973
Mailing Address - Country:US
Mailing Address - Phone:912-554-8500
Mailing Address - Fax:912-449-7060
Practice Address - Street 1:1113 E OGLETHORPE HWY
Practice Address - Street 2:
Practice Address - City:HINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:31313-1200
Practice Address - Country:US
Practice Address - Phone:912-368-3502
Practice Address - Fax:912-368-6844
Is Sole Proprietor?:No
Enumeration Date:2018-07-17
Last Update Date:2018-07-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GALPC010343101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional