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General NPI Number Information
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NPI Number | 1578908828
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Entity Type | Individual
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Provider Name | CONNIE T THOMPSON LPC
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Gender | Female
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Dates
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Enumeration Date | 04/30/2013
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Last Update Date | 04/30/2013
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Provider Practice Location Address
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Address Line | 2501 N 3RD ST
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City | HARRISBURG
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State | PA
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Zip | 17110-1904
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Country | US
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Telephone | 717-782-6480
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Fax |
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Provider Business Mailing Address
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Address Line | 1381 HIGHLAND AVENUE RD
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City | GETTYSBURG
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State | PA
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Zip | 17325-7704
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Country | US
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Telephone | 717-334-8722
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | PC006490
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License Number State | PA
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