Provider Demographics
NPI:1841424827
Name:SUZANNE BALLARD THOMPSON
Entity Type:Organization
Organization Name:SUZANNE BALLARD THOMPSON
Other - Org Name:THOMPSON AND INTEMANN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:LPC
Authorized Official - Prefix:
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:BALLARD THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-602-5518
Mailing Address - Street 1:2036 AURORA LN
Mailing Address - Street 2:
Mailing Address - City:FRANKLINTON
Mailing Address - State:NC
Mailing Address - Zip Code:27525-8375
Mailing Address - Country:US
Mailing Address - Phone:919-602-5518
Mailing Address - Fax:919-861-8893
Practice Address - Street 1:839C WAKE FOREST BUSINESS PARK
Practice Address - Street 2:
Practice Address - City:WAKE FOREST
Practice Address - State:NC
Practice Address - Zip Code:27587-6561
Practice Address - Country:US
Practice Address - Phone:919-602-5518
Practice Address - Fax:919-861-8893
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-06
Last Update Date:2009-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty