Healthcare Provider Details

I. General information

NPI: 1396225926
Provider Name (Legal Business Name): KAMBRIA THORNE LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KAMBRIA THOMPSON CMHT

II. Dates (important events)

Enumeration Date: 08/14/2018
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1021 SPRING LAKE BLVD
BYRAM MS
39272-6511
US

IV. Provider business mailing address

1021 SPRING LAKE BLVD
BYRAM MS
39272-6511
US

V. Phone/Fax

Practice location:
  • Phone: 769-213-1751
  • Fax: 601-202-3041
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC0023843
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMHC01792
License Number StateRI
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2742
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: