Provider Demographics
NPI:1871903138
Name:PRISCILLA THOMPSON, PLLC
Entity type:Organization
Organization Name:PRISCILLA THOMPSON, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:PRISCILLA
Authorized Official - Middle Name:S
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:LCMHC
Authorized Official - Phone:603-565-0592
Mailing Address - Street 1:98 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BRADFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03221-6502
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:210 RUMFORD ST
Practice Address - Street 2:SUITE 2
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-4584
Practice Address - Country:US
Practice Address - Phone:603-565-0592
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PRISCILLA THOMPSON, PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-05-07
Last Update Date:2014-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH823101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty