Provider Demographics
NPI:1366269300
Name:THOMPSON COUNSELING AND DUI SERVICES
Entity type:Organization
Organization Name:THOMPSON COUNSELING AND DUI SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/COUNSELOR
Authorized Official - Prefix:MS
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:R
Authorized Official - Last Name:GARRISON
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:618-237-1060
Mailing Address - Street 1:9 CUSUMANO PROFESSIONAL PLAZA DR
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:IL
Mailing Address - Zip Code:62864-6736
Mailing Address - Country:US
Mailing Address - Phone:618-242-4290
Mailing Address - Fax:618-242-4209
Practice Address - Street 1:9 CUSUMANO PROFESSIONAL PLAZA DR
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:IL
Practice Address - Zip Code:62864-6736
Practice Address - Country:US
Practice Address - Phone:618-242-4290
Practice Address - Fax:618-242-4209
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-23
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty