Provider Demographics
NPI:1831849827
Name:MCKINNEY-THOMPSON, ALLISON MARIE (LCPC)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:MARIE
Last Name:MCKINNEY-THOMPSON
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1715 RATTLESNAKE DR
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59802-3517
Mailing Address - Country:US
Mailing Address - Phone:406-465-1785
Mailing Address - Fax:
Practice Address - Street 1:1715 RATTLESNAKE DR
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59802-3517
Practice Address - Country:US
Practice Address - Phone:406-465-1785
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-24
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-LCPC-LIC-55410101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional