1104405232 NPI number — MS. YOULANDA THOMPSON MS, LMHC

Table of content: MS. YOULANDA THOMPSON MS, LMHC (NPI 1104405232)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1104405232 NPI number — MS. YOULANDA THOMPSON MS, LMHC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
THOMPSON
Provider First Name:
YOULANDA
Provider Middle Name:
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
MS, LMHC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
THOMPSON
Provider Other First Name:
YOULANDA
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
YOULANDA THOMPSON MS
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1104405232
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/06/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1016 CLEMMONS ST STE 300
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
JUPITER
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33477-3305
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
561-743-1037
Provider Business Mailing Address Fax Number:
561-743-1037

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1720 E TIFFANY DR STE 102
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MANGONIA PARK
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33407-3235
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
561-844-3556
Provider Business Practice Location Address Fax Number:
561-845-0316
Provider Enumeration Date:
04/06/2021

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  MH18150 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com