Provider Demographics
NPI:1932509312
Name:THOMPSON, ROXANNE (MA, LPC)
Entity Type:Individual
Prefix:
First Name:ROXANNE
Middle Name:
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1828 S CODY ST
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80232-6615
Mailing Address - Country:US
Mailing Address - Phone:720-218-1437
Mailing Address - Fax:303-722-2324
Practice Address - Street 1:2133 S BELLAIRE ST STE 11
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-4933
Practice Address - Country:US
Practice Address - Phone:720-218-1437
Practice Address - Fax:303-722-2324
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-04
Last Update Date:2014-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2728101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health