Healthcare Provider Details

I. General information

NPI: 1700707577
Provider Name (Legal Business Name): WILLIAM SHANE THOMPSON LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/24/2026
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 SW GAGE BLVD
TOPEKA KS
66604-3340
US

IV. Provider business mailing address

3020 SW 33RD ST
TOPEKA KS
66614-3228
US

V. Phone/Fax

Practice location:
  • Phone: 785-272-0778
  • Fax:
Mailing address:
  • Phone: 636-698-5460
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number05500
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: