Provider Demographics
NPI:1194025197
Name:THOMPSON, AIMEE NICOLE (LMHC)
Entity type:Individual
Prefix:
First Name:AIMEE
Middle Name:NICOLE
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10701 RANCHITOS RD NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87122-2516
Mailing Address - Country:US
Mailing Address - Phone:505-270-0844
Mailing Address - Fax:
Practice Address - Street 1:500 17TH ST NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87104-1307
Practice Address - Country:US
Practice Address - Phone:505-270-0844
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-25
Last Update Date:2010-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMT-0131471101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health