Provider Demographics
NPI:1861670259
Name:THOMPSON, SUSAN MARIA (MA)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:MARIA
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1563 MEADOW PEAK VW APT 132
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80906-7827
Mailing Address - Country:US
Mailing Address - Phone:719-375-5224
Mailing Address - Fax:
Practice Address - Street 1:1563 MEADOW PEAK VW APT 132
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80906-7827
Practice Address - Country:US
Practice Address - Phone:719-375-5224
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-07
Last Update Date:2008-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor