Provider Demographics
NPI:1184136616
Name:THOMPSON COUNSELING
Entity type:Organization
Organization Name:THOMPSON COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:A
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:256-239-0314
Mailing Address - Street 1:500 COUNTRY LN
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:AL
Mailing Address - Zip Code:36203-3600
Mailing Address - Country:US
Mailing Address - Phone:256-239-0314
Mailing Address - Fax:256-236-2547
Practice Address - Street 1:2700 BRIGHTON AVE
Practice Address - Street 2:
Practice Address - City:ANNISTON
Practice Address - State:AL
Practice Address - Zip Code:36207-2974
Practice Address - Country:US
Practice Address - Phone:256-239-0314
Practice Address - Fax:256-236-2547
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-24
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1206-1538C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL198269Medicaid