MEDICARE: ANGELA JOY THOMPSON 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	101YM0800X	Mental Health Counselor	011496	GA

General Provider Information

NPI Number	:	1710650890
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELA JOY THOMPSON LPC

Provider Business Mailing Address
First Line	:	11706 MERCY BLVD STE 8
Second Line	:
City	:	SAVANNAH
State	:	GA
Zip	:	31419-1751
Country	:	US
Telephone Number	:	912-228-5655
Fax Number	:

Provider Business Practice Location Address
First Line	:	11706 MERCY BLVD STE 8
Second Line	:
City	:	SAVANNAH
State	:	GA
Zip	:	31419-1751
Country	:	US
Telephone Number	:	912-228-5655
Fax Number	:

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

Provider Enumeration Date	:	07/26/2021
Last Update Date	:	02/25/2026

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