MEDICARE: JUVON 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
1	101YM0800X	Mental Health Counselor
2	101YM0800X	Mental Health Counselor		KY

General Provider Information

NPI Number	:	1942901707
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUVON THOMPSON

Provider Business Mailing Address
First Line	:	4410 LOCHRIDGE PKWY
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40299-1128
Country	:	US
Telephone Number	:	502-322-4229
Fax Number	:

Provider Business Practice Location Address
First Line	:	2615 HALE AVE
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40211-1235
Country	:	US
Telephone Number	:	502-322-4229
Fax Number	:

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

Provider Enumeration Date	:	03/16/2023
Last Update Date	:	01/11/2026

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Directions to “ JUVON THOMPSON ” Practice Location

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