Provider Demographics
NPI:1932392974
Name:THOMPSON, NICOLE OLIVIA (LPC, NCC)
Entity Type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:OLIVIA
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 HOLLINGSWORTH RD
Mailing Address - Street 2:
Mailing Address - City:FOUR OAKS
Mailing Address - State:NC
Mailing Address - Zip Code:27524-9664
Mailing Address - Country:US
Mailing Address - Phone:919-272-8891
Mailing Address - Fax:
Practice Address - Street 1:9101 FAYETTEVILLE RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27603-5655
Practice Address - Country:US
Practice Address - Phone:919-866-5471
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-23
Last Update Date:2007-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4061101Y00000X
NC220313101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor