Provider Demographics
NPI:1255128104
Name:THOMPSON, MICHAEL J (PHD, LP)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:J
Last Name:THOMPSON
Suffix:
Gender:
Credentials:PHD, LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 3RD AVE APT 12R
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-2516
Mailing Address - Country:US
Mailing Address - Phone:212-799-3146
Mailing Address - Fax:
Practice Address - Street 1:205 3RD AVE APT 12R
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-2516
Practice Address - Country:US
Practice Address - Phone:212-799-3146
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-23
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001252102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst