Healthcare Provider Details

I. General information

NPI: 1235146747
Provider Name (Legal Business Name): CAROLINE M. THOMPSON LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CAROLINE SCHLEIFER LPC

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 01/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

291 PARK AVE
DANVILLE VA
24541
US

IV. Provider business mailing address

291 PARK AVE
DANVILLE VA
24541
US

V. Phone/Fax

Practice location:
  • Phone: 434-799-3310
  • Fax: 434-799-3317
Mailing address:
  • Phone: 434-799-3310
  • Fax: 434-799-3317

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number0718000101
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0701001762
License Number StateVA
# 3
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: