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General NPI Number Information
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NPI Number | 1053870246
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Entity Type | Individual
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Provider Name | LAYNA BRENAE THOMPSON LCSW, LISW-CP
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Gender | Female
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Dates
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Enumeration Date | 03/18/2019
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Last Update Date | 11/13/2025
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Provider Practice Location Address
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Address Line | 134 JEPSON WAY
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City | POOLER
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State | GA
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Zip | 31322-9836
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Country | US
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Telephone | 912-200-6396
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Fax | 855-223-9969
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Provider Business Mailing Address
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Address Line | 134 JEPSON WAY
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City | POOLER
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State | GA
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Zip | 31322-9836
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Country | US
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Telephone | 912-200-6396
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Fax | 855-223-9969
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | SW.18011CP
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | CSW009648
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW.18011CP
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License Number State | SC
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Taxonomy #4
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CSW009648
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License Number State | GA
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