Provider Demographics
NPI:1649689456
Name:THOMPSON, TAYLOR (MS, LPC-INTERN)
Entity type:Individual
Prefix:MISS
First Name:TAYLOR
Middle Name:
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:MS, LPC-INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 S WOODROW LN
Mailing Address - Street 2:# 5
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76205-6308
Mailing Address - Country:US
Mailing Address - Phone:940-765-6487
Mailing Address - Fax:
Practice Address - Street 1:103 S WOODROW LN
Practice Address - Street 2:# 5
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76205-6308
Practice Address - Country:US
Practice Address - Phone:940-765-6487
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-06
Last Update Date:2014-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX72703101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health