Provider Demographics
NPI:1427607514
Name:THOMPSON, DEANA LEE (LPCA)
Entity type:Individual
Prefix:
First Name:DEANA
Middle Name:LEE
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 GRAY SAVAGE RD
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:KY
Mailing Address - Zip Code:42602-9200
Mailing Address - Country:US
Mailing Address - Phone:606-306-2191
Mailing Address - Fax:
Practice Address - Street 1:45 SURREY HILL RD
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:KY
Practice Address - Zip Code:42633-2320
Practice Address - Country:US
Practice Address - Phone:606-387-0291
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-10
Last Update Date:2019-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY246909101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health