MEDICARE: MR. DAVID J. THOMPSON M.A., LPC

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	101YP2500X	Professional Counselor	68785	TX

General Provider Information

NPI Number	:	1649537614
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DAVID J. THOMPSON M.A., LPC

Provider Business Mailing Address
First Line	:	PO BOX 5040
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75208-9040
Country	:	US
Telephone Number	:	972-697-7957
Fax Number	:

Provider Business Practice Location Address
First Line	:	400 N SAINT PAUL ST
Second Line	:	STE 235
City	:	DALLAS
State	:	TX
Zip	:	75201-3114
Country	:	US
Telephone Number	:	214-814-5444
Fax Number	:

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

Provider Enumeration Date	:	04/16/2012
Last Update Date	:	03/14/2017

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