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General NPI Number Information
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NPI Number | 1720964810
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Entity Type | Individual
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Provider Name | AMBER N THOMPSON M.A.
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Gender | Female
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Dates
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Enumeration Date | 08/13/2025
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Last Update Date | 08/13/2025
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Provider Practice Location Address
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Address Line | 4829 E BELTLINE AVE NE STE 302
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City | GRAND RAPIDS
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State | MI
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Zip | 49525-9350
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Country | US
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Telephone | 616-226-6522
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Fax |
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Provider Business Mailing Address
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Address Line | 7 CLEARWATER CT
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City | STREAMWOOD
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State | IL
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Zip | 60107-2310
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Country | US
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Telephone | 331-200-9988
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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 | 6451024541
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License Number State | MI
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