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NPI Code Detail

MEDICARE: TONI THOMPSON

MEDICARE: TONI THOMPSON
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
1101YM0800XMental Health Counselor
2171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1740713791
Entity Type Code : Individual
Provider Name (Legal Business Name) : TONI THOMPSON
Provider Business Mailing Address
First Line : 2608 HWY 528
Second Line :
City : PRINCETON
State : LA
Zip : 71067
Country : US
Telephone Number : 318-716-1717
Fax Number : 318-716-1793
Provider Business Practice Location Address
First Line : 4021 GREENWOOD RD
Second Line :
City : SHREVEPORT
State : LA
Zip : 71109-6422
Country : US
Telephone Number : 318-716-1717
Fax Number : 318-716-1793
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/06/2017
Last Update Date : 03/12/2019

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Directions to “ TONI THOMPSON ” Practice Location

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