Provider Demographics
NPI:1447368097
Name:THOMPSON-BEARD, DEBORAH A (MSFT, LCPC, NCC)
Entity type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:A
Last Name:THOMPSON-BEARD
Suffix:
Gender:F
Credentials:MSFT, LCPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:705 W MASONIC ST
Mailing Address - Street 2:APT A
Mailing Address - City:EDINBURG
Mailing Address - State:IL
Mailing Address - Zip Code:62531-9613
Mailing Address - Country:US
Mailing Address - Phone:217-204-2068
Mailing Address - Fax:
Practice Address - Street 1:3000 LENHART RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:IL
Practice Address - Zip Code:62711-9203
Practice Address - Country:US
Practice Address - Phone:217-698-7150
Practice Address - Fax:217-698-7085
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2016-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.006969101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional