Provider Demographics
NPI:1396710729
Name:THOMSON, JAMES B (LCPC)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:B
Last Name:THOMSON
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1240 BAMBURG CT
Mailing Address - Street 2:SUITE 3A
Mailing Address - City:HANOVER PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60133-5243
Mailing Address - Country:US
Mailing Address - Phone:630-372-6599
Mailing Address - Fax:
Practice Address - Street 1:1240 BAMBURG CT
Practice Address - Street 2:SUITE 3A
Practice Address - City:HANOVER PARK
Practice Address - State:IL
Practice Address - Zip Code:60133-5243
Practice Address - Country:US
Practice Address - Phone:630-372-6599
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional