MEDICARE: MRS. KIMBERLY ANN THOMPSON-TEXIDOR LMFT

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	106H00000X	Marriage & Family Therapist	0001705	CO
2	106H00000X	Marriage & Family Therapist	35002233A	IN

General Provider Information

NPI Number	:	1558680116
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KIMBERLY ANN THOMPSON-TEXIDOR LMFT

Provider Business Mailing Address
First Line	:	7018 RAINELLE DR
Second Line	:
City	:	LANESVILLE
State	:	IN
Zip	:	47136-9478
Country	:	US
Telephone Number	:	303-717-4039
Fax Number	:

Provider Business Practice Location Address
First Line	:	400 PEARL ST STE 202B
Second Line	:
City	:	NEW ALBANY
State	:	IN
Zip	:	47150-3451
Country	:	US
Telephone Number	:	720-808-0139
Fax Number	:

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

Provider Enumeration Date	:	05/21/2010
Last Update Date	:	07/28/2024

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