Provider Demographics
NPI:1881917110
Name:THOMPSON, EHLAN H (LMFT)
Entity type:Individual
Prefix:MRS
First Name:EHLAN
Middle Name:H
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:904 6TH AVENUE CT NE
Mailing Address - Street 2:
Mailing Address - City:ISANTI
Mailing Address - State:MN
Mailing Address - Zip Code:55040-3208
Mailing Address - Country:US
Mailing Address - Phone:637-444-8700
Mailing Address - Fax:637-434-0192
Practice Address - Street 1:904 6TH AVENUE CT NE
Practice Address - Street 2:
Practice Address - City:ISANTI
Practice Address - State:MN
Practice Address - Zip Code:55040
Practice Address - Country:US
Practice Address - Phone:763-444-8700
Practice Address - Fax:763-434-0192
Is Sole Proprietor?:No
Enumeration Date:2010-03-01
Last Update Date:2018-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1705106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist