Provider Demographics
NPI:1124112040
Name:THOMPSON, MELINDA MORROW (LPC)
Entity type:Individual
Prefix:MRS
First Name:MELINDA
Middle Name:MORROW
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 1:408 TARROW ST E
Mailing Address - Street 2:
Mailing Address - City:COLLEGE STATION
Mailing Address - State:TX
Mailing Address - Zip Code:77840-7811
Mailing Address - Country:US
Mailing Address - Phone:979-268-1111
Mailing Address - Fax:979-268-5803
Practice Address - Street 1:408 TARROW ST E
Practice Address - Street 2:
Practice Address - City:COLLEGE STATION
Practice Address - State:TX
Practice Address - Zip Code:77840-7811
Practice Address - Country:US
Practice Address - Phone:979-268-1111
Practice Address - Fax:979-268-5803
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13342101Y00000X
TX12405103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselor
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX82856LOtherBLUE CROSS BLUE SHIELD