Healthcare Provider Details

I. General information

NPI: 1275333452
Provider Name (Legal Business Name): KATHERINE THOMPSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/17/2025
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9007 WASHINGTON ST NE
ALBUQUERQUE NM
87113-2722
US

IV. Provider business mailing address

5312 GABLE ST NW
ALBUQUERQUE NM
87120-4439
US

V. Phone/Fax

Practice location:
  • Phone: 505-503-0272
  • Fax:
Mailing address:
  • Phone: 504-920-8844
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberCTB-2026-0508
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: