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NPI Code Detail

MEDICARE: MARY THOMPSON LPCC

MEDICARE: MARY THOMPSON LPCC
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
1101YP2500XProfessional Counselor269682KY

General Provider Information

NPI Number : 1508345042
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY THOMPSON LPCC
Provider Business Mailing Address
First Line : 998 BROOKS INDUSTRIAL RD
Second Line :
City : SHELBYVILLE
State : KY
Zip : 40065-8154
Country : US
Telephone Number : 502-633-1315
Fax Number :
Provider Business Practice Location Address
First Line : 998 BROOKS INDUSTRIAL RD
Second Line :
City : SHELBYVILLE
State : KY
Zip : 40065-8154
Country : US
Telephone Number : 502-633-1315
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/07/2018
Last Update Date : 05/20/2021

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Directions to “ MARY THOMPSON LPCC” Practice Location

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