Provider Demographics
NPI:1780667741
Name:THOMPSON, SCOTT D (LMHC)
Entity Type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:D
Last Name:THOMPSON
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:72 CARRINGTON LN
Mailing Address - Street 2:
Mailing Address - City:UXBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:01569-3215
Mailing Address - Country:US
Mailing Address - Phone:508-579-1498
Mailing Address - Fax:
Practice Address - Street 1:915 SOUTH ST
Practice Address - Street 2:
Practice Address - City:FITCHBURG
Practice Address - State:MA
Practice Address - Zip Code:01420-6252
Practice Address - Country:US
Practice Address - Phone:978-345-4147
Practice Address - Fax:978-345-1616
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MALM1058OtherBCBS
346800OtherTRICARE