Provider Demographics
NPI:1245887736
Name:THOMPSON, ELLA MORGAN (LPC)
Entity type:Individual
Prefix:
First Name:ELLA
Middle Name:MORGAN
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6268
Mailing Address - Street 2:
Mailing Address - City:SHEPPARD AFB
Mailing Address - State:TX
Mailing Address - Zip Code:76311-0268
Mailing Address - Country:US
Mailing Address - Phone:940-263-1359
Mailing Address - Fax:940-283-9406
Practice Address - Street 1:1426 DANBERRY ST
Practice Address - Street 2:
Practice Address - City:BURKBURNETT
Practice Address - State:TX
Practice Address - Zip Code:76354-3116
Practice Address - Country:US
Practice Address - Phone:940-263-1359
Practice Address - Fax:940-283-9406
Is Sole Proprietor?:No
Enumeration Date:2019-08-20
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX89090101YP2500X
VA0701008536101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1659424448Medicaid