Provider Demographics
NPI:1013663616
Name:THOMPSON, MARCY (LCPC, NCC)
Entity Type:Individual
Prefix:MRS
First Name:MARCY
Middle Name:
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:LCPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3077 E STONE POINT DR
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83712-8573
Mailing Address - Country:US
Mailing Address - Phone:208-371-7040
Mailing Address - Fax:
Practice Address - Street 1:3077 E STONE POINT DR
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83712-8573
Practice Address - Country:US
Practice Address - Phone:208-371-7040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-23
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID2794101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health