Provider Demographics
NPI:1831543321
Name:THOMPSON, LORALYNNE (BHP, LPC)
Entity type:Individual
Prefix:
First Name:LORALYNNE
Middle Name:
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:BHP, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22424 S ELLSWORTH LOOP RD UNIT 9
Mailing Address - Street 2:
Mailing Address - City:QUEEN CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85142-7027
Mailing Address - Country:US
Mailing Address - Phone:480-331-1567
Mailing Address - Fax:
Practice Address - Street 1:7400 S POWER RD STE 116
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85297-9282
Practice Address - Country:US
Practice Address - Phone:480-988-5003
Practice Address - Fax:480-988-9799
Is Sole Proprietor?:No
Enumeration Date:2016-04-20
Last Update Date:2024-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLAC-15752101YM0800X
AZLPC-17864101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health