Provider Demographics
NPI:1699529792
Name:THOMPSON, PETER (LPC)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:
Last Name:THOMPSON
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 RICHARD LEE LN
Mailing Address - Street 2:
Mailing Address - City:PHOENIXVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19460-1900
Mailing Address - Country:US
Mailing Address - Phone:585-698-4905
Mailing Address - Fax:
Practice Address - Street 1:29 RICHARD LEE LN
Practice Address - Street 2:
Practice Address - City:PHOENIXVILLE
Practice Address - State:PA
Practice Address - Zip Code:19460-1900
Practice Address - Country:US
Practice Address - Phone:585-698-4905
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-15
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC017011101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health