Provider Demographics
NPI:1104416064
Name:DAWNA THOMPSON PSYCHOLOGY LLC
Entity type:Organization
Organization Name:DAWNA THOMPSON PSYCHOLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAWNA
Authorized Official - Middle Name:FARRAR
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:703-618-7746
Mailing Address - Street 1:12221 HENDERSON RD
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:VA
Mailing Address - Zip Code:20124-2213
Mailing Address - Country:US
Mailing Address - Phone:703-618-7746
Mailing Address - Fax:
Practice Address - Street 1:4031 UNIVERSITY DR STE 100
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-3400
Practice Address - Country:US
Practice Address - Phone:571-354-7248
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-24
Last Update Date:2021-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty