Healthcare Provider Details

I. General information

NPI: 1952220774
Provider Name (Legal Business Name): LAURA E THOMPSON PPD, CLC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5790 REXFORD CT UNIT J
WEST SPRINGFIELD VA
22152-1086
US

IV. Provider business mailing address

5790 REXFORD CT UNIT J
WEST SPRINGFIELD VA
22152-1086
US

V. Phone/Fax

Practice location:
  • Phone: 845-837-2668
  • Fax:
Mailing address:
  • Phone: 845-837-2668
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License Number374640
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: