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NPI 1578591806

NPI 1578591806 : GARY L THOMPSON M.A., M.S.W. : KALAMAZOO, MI

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General NPI Number Information
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    NPI Number           |    1578591806
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    Entity Type          |    Individual 
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    Provider Name        |    GARY L THOMPSON M.A., M.S.W.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    06/28/2006
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    Last Update Date     |    01/04/2026
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Provider Practice Location Address
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    Address Line         |    7734 S 8TH ST 
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    City                 |    KALAMAZOO
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    State                |    MI
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    Zip                  |    49009-9796
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    Country              |    US
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    Telephone            |    269-372-9658
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    Fax                  |    269-743-1000
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Provider Business Mailing Address
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    Address Line         |    7734 S 8TH ST 
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    City                 |    KALAMAZOO
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    State                |    MI
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    Zip                  |    49009-9796
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    Country              |    US
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    Telephone            |    269-372-9658
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    Fax                  |    269-743-1000
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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       |    6401002666
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    License Number State |    MI
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