MEDICARE: CARA M. THOMPSON PHD, LMFT, LMFT/S

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	2603	NC
2	101YM0800X	Mental Health Counselor

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	3000641104	OTHER	SC	WORKER'S COMP

General Provider Information

NPI Number	:	1134351042
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARA M. THOMPSON PHD, LMFT, LMFT/S

Provider Business Mailing Address
First Line	:	2512 INDEPENDENCE BLVD STE 100
Second Line	:
City	:	WILMINGTON
State	:	NC
Zip	:	28412-0019
Country	:	US
Telephone Number	:	910-833-1069
Fax Number	:

Provider Business Practice Location Address
First Line	:	2512 INDEPENDENCE BLVD STE 100
Second Line	:
City	:	WILMINGTON
State	:	NC
Zip	:	28412-0019
Country	:	US
Telephone Number	:	910-833-1069
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/12/2009
Last Update Date	:	12/01/2023

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