Provider Demographics
NPI:1205243227
Name:THOMPSON, JANIE LYNN (MED, LPC)
Entity type:Individual
Prefix:
First Name:JANIE
Middle Name:LYNN
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:MED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 LAKEMONT DR
Mailing Address - Street 2:
Mailing Address - City:DALTON
Mailing Address - State:GA
Mailing Address - Zip Code:30720-5267
Mailing Address - Country:US
Mailing Address - Phone:606-733-0719
Mailing Address - Fax:
Practice Address - Street 1:700 LAKEMONT DR
Practice Address - Street 2:
Practice Address - City:DALTON
Practice Address - State:GA
Practice Address - Zip Code:30720-5267
Practice Address - Country:US
Practice Address - Phone:606-733-0719
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-22
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC014065101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional