Provider Demographics
NPI:1730076803
Name:THOMPSON, TAMMY S (LCMHCA)
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:S
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:LCMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 LINDSEY LN
Mailing Address - Street 2:
Mailing Address - City:BENSON
Mailing Address - State:NC
Mailing Address - Zip Code:27504-6291
Mailing Address - Country:US
Mailing Address - Phone:919-756-8028
Mailing Address - Fax:
Practice Address - Street 1:141K TECHNOLOGY DR # K
Practice Address - Street 2:
Practice Address - City:GARNER
Practice Address - State:NC
Practice Address - Zip Code:27529-7940
Practice Address - Country:US
Practice Address - Phone:910-676-1043
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-21
Last Update Date:2025-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA21600101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health