Healthcare Provider Details

I. General information

NPI: 1619486594
Provider Name (Legal Business Name): KALI THOMPSON, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

237 N PRINCE ST STE 204
LANCASTER PA
17603-4062
US

IV. Provider business mailing address

237 N PRINCE ST STE 204
LANCASTER PA
17603-4062
US

V. Phone/Fax

Practice location:
  • Phone: 717-406-3877
  • Fax:
Mailing address:
  • Phone: 717-406-3877
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License NumberCW018375
License Number StatePA

VIII. Authorized Official

Name: KALI LENN THOMPSON
Title or Position: PSYCHOTHERAPIST
Credential: LCSW
Phone: 717-406-3877