Provider Demographics
NPI:1841885290
Name:THOMPSON, JAMES EDWARD JR
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:EDWARD
Last Name:THOMPSON
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6851 WEISER ST APT 111
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32821-8300
Mailing Address - Country:US
Mailing Address - Phone:321-439-3927
Mailing Address - Fax:
Practice Address - Street 1:1701 PARK CENTER DR STE 2101701
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32835-6235
Practice Address - Country:US
Practice Address - Phone:407-730-3837
Practice Address - Fax:407-730-3869
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-08
Last Update Date:2021-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health