Provider Demographics
NPI:1770896698
Name:THOMPSON, GREGORY J (MA, LMHC)
Entity type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:J
Last Name:THOMPSON
Suffix:
Gender:M
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9720 SW BURTON DR
Mailing Address - Street 2:
Mailing Address - City:VASHON
Mailing Address - State:WA
Mailing Address - Zip Code:98070-7002
Mailing Address - Country:US
Mailing Address - Phone:206-947-0523
Mailing Address - Fax:206-463-5513
Practice Address - Street 1:9720 SW BURTON DR
Practice Address - Street 2:
Practice Address - City:VASHON
Practice Address - State:WA
Practice Address - Zip Code:98070-7002
Practice Address - Country:US
Practice Address - Phone:206-947-0523
Practice Address - Fax:206-463-5513
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-20
Last Update Date:2010-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH 60159956101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health