Provider Demographics
NPI:1821639535
Name:THOMPSON, STEPHANI ERIN (MA, PLMHP)
Entity Type:Individual
Prefix:
First Name:STEPHANI
Middle Name:ERIN
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:MA, PLMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:810 W REID AVE STE 4
Mailing Address - Street 2:
Mailing Address - City:NORTH PLATTE
Mailing Address - State:NE
Mailing Address - Zip Code:69101-6582
Mailing Address - Country:US
Mailing Address - Phone:308-534-0090
Mailing Address - Fax:
Practice Address - Street 1:810 W REID AVE STE 4
Practice Address - Street 2:
Practice Address - City:NORTH PLATTE
Practice Address - State:NE
Practice Address - Zip Code:69101-6582
Practice Address - Country:US
Practice Address - Phone:308-534-0090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-03
Last Update Date:2019-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE11971101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional