Provider Demographics
NPI:1730648684
Name:THOMPSON, CHARIS OLIVIA (LPC)
Entity Type:Individual
Prefix:
First Name:CHARIS
Middle Name:OLIVIA
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 1:530 FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12305-2008
Mailing Address - Country:US
Mailing Address - Phone:518-381-8911
Mailing Address - Fax:518-377-4292
Practice Address - Street 1:1330 INVERNESS DR STE 400
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80910-3739
Practice Address - Country:US
Practice Address - Phone:970-310-3406
Practice Address - Fax:888-965-4615
Is Sole Proprietor?:No
Enumeration Date:2019-03-19
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0016846101YP2500X
NY100089-01101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health