Provider Demographics
NPI:1992980965
Name:THOMPSON, MARK K (LMHC, CAP)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:K
Last Name:THOMPSON
Suffix:
Gender:M
Credentials:LMHC, CAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4880 N CITATION DR
Mailing Address - Street 2:#104
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33445-6552
Mailing Address - Country:US
Mailing Address - Phone:561-699-9429
Mailing Address - Fax:
Practice Address - Street 1:15200 JOG RD
Practice Address - Street 2:STE #201
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33446-1247
Practice Address - Country:US
Practice Address - Phone:561-450-8328
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-08
Last Update Date:2008-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 8939101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health