Provider Demographics
NPI:1639989585
Name:THOMPSON, RAEGAN PAIGE (LPCC)
Entity type:Individual
Prefix:
First Name:RAEGAN
Middle Name:PAIGE
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:LPCC
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 363
Mailing Address - Street 2:
Mailing Address - City:HARRODSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:40330-0363
Mailing Address - Country:US
Mailing Address - Phone:859-319-6032
Mailing Address - Fax:859-908-2501
Practice Address - Street 1:100 S MAIN ST
Practice Address - Street 2:
Practice Address - City:HARRODSBURG
Practice Address - State:KY
Practice Address - Zip Code:40330-1633
Practice Address - Country:US
Practice Address - Phone:859-733-9241
Practice Address - Fax:859-908-2501
Is Sole Proprietor?:No
Enumeration Date:2025-01-13
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY296597101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional