Provider Demographics
NPI:1740834936
Name:THOMPSON, LECIA (LPC)
Entity type:Individual
Prefix:
First Name:LECIA
Middle Name:
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 1:11830 CANON BLVD STE C
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-2568
Mailing Address - Country:US
Mailing Address - Phone:757-921-8377
Mailing Address - Fax:757-210-3707
Practice Address - Street 1:11830 CANON BLVD STE C
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-2568
Practice Address - Country:US
Practice Address - Phone:757-921-8377
Practice Address - Fax:757-210-3707
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-26
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701008500101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional