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General NPI Number Information
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NPI Number | 1710850763
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Entity Type | Organization
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Legal Business Name | LAKE THOMPSON COUNSELING
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Dates
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Enumeration Date | 09/25/2025
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Last Update Date | 09/25/2025
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Provider Practice Location Address
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Address Line | 55 S 3RD E
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City | REXBURG
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State | ID
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Zip | 83440-2001
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Country | US
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Telephone | 208-289-0341
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Fax |
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Provider Business Mailing Address
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Address Line | 55 S 3RD E
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City | REXBURG
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State | ID
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Zip | 83440-2001
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Country | US
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Telephone | 480-415-5454
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Fax |
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Authorized Official
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Title or Position | COUNSELOR
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Name | MEGAN THOMPSON
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Credential | LCSW
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Telephone | 480-415-5454
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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