MEDICARE: MS. JOANNE THOMPSON LPCC, LICDC, EAPI

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	OH1-45-8322	OH
2	101YA0400X	Addiction (Substance Use Disorder) Counselor	011127	OH
3	101YM0800X	Mental Health Counselor	E.1700361	OH

General Provider Information

NPI Number	:	1477619393
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JOANNE THOMPSON LPCC, LICDC, EAPI

Provider Business Mailing Address
First Line	:	2932 SOUTH 3BS AND K ROAD
Second Line	:
City	:	GALENA
State	:	OH
Zip	:	43021
Country	:	US
Telephone Number	:	614-327-0668
Fax Number	:	740-548-0709

Provider Business Practice Location Address
First Line	:	2932 S 3 BS AND K RD
Second Line	:
City	:	GALENA
State	:	OH
Zip	:	43021
Country	:	US
Telephone Number	:	614-327-0668
Fax Number	:	740-548-0709

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/28/2006
Last Update Date	:	07/03/2018

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