Provider Demographics
NPI:1063224657
Name:THOMPSON, JULIETTE MARIE (LPC)
Entity type:Individual
Prefix:
First Name:JULIETTE
Middle Name:MARIE
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 HILLPOINT BLVD APT 814
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23434-8195
Mailing Address - Country:US
Mailing Address - Phone:757-514-1458
Mailing Address - Fax:757-809-0712
Practice Address - Street 1:601 HILLPOINT BLVD APT 814
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23434-8195
Practice Address - Country:US
Practice Address - Phone:757-514-1458
Practice Address - Fax:757-809-0712
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-22
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701014456101YA0400X, 101YM0800X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health