Provider Demographics
NPI:1811011943
Name:THOMPSEN, CARRIE (LPCMH)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:
Last Name:THOMPSEN
Suffix:
Gender:F
Credentials:LPCMH
Other - Prefix:
Other - First Name:CARRIE
Other - Middle Name:
Other - Last Name:THOMPSEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1632 SAVANNAH RD STE 5
Mailing Address - Street 2:
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958-1659
Mailing Address - Country:US
Mailing Address - Phone:973-615-0238
Mailing Address - Fax:302-827-4382
Practice Address - Street 1:1632 SAVANNAH RD STE 5
Practice Address - Street 2:
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958-1659
Practice Address - Country:US
Practice Address - Phone:973-615-0238
Practice Address - Fax:302-827-4382
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2018-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00054100101YP2500X
DEPC-0000712101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional