Provider Demographics
NPI:1750531216
Name:THOMPSON, ALTHEA R (LPC)
Entity type:Individual
Prefix:
First Name:ALTHEA
Middle Name:R
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:ALTHEA
Other - Middle Name:R
Other - Last Name:THOMPSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:2000 CENTENARY CIR
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75601-3524
Mailing Address - Country:US
Mailing Address - Phone:903-235-1040
Mailing Address - Fax:
Practice Address - Street 1:2000 CENTENARY CIR
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75601-3524
Practice Address - Country:US
Practice Address - Phone:903-407-3136
Practice Address - Fax:903-687-4100
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-22
Last Update Date:2023-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16077101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health