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General NPI Number Information
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NPI Number | 1053289959
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Entity Type | Individual
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Provider Name | TAMMY THOMPSON LCDC
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Gender | Female
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Dates
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Enumeration Date | 10/23/2025
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Last Update Date | 10/23/2025
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Provider Practice Location Address
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Address Line | 1534 N HAMPTON RD STE C
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City | DESOTO
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State | TX
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Zip | 75115-2505
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Country | US
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Telephone | 469-225-9850
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Fax | 972-379-9933
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Provider Business Mailing Address
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Address Line | 7402 LAKE RIDGE PKWY APT 1422
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City | GRAND PRAIRIE
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State | TX
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Zip | 75054-0346
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Country | US
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Telephone | 817-390-0285
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 17565
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License Number State | TX
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