Provider Demographics
NPI:1538041819
Name:THOMPSON, NADINE
Entity type:Individual
Prefix:
First Name:NADINE
Middle Name:
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:277 E AMADOR AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88001-3675
Mailing Address - Country:US
Mailing Address - Phone:505-392-3482
Mailing Address - Fax:
Practice Address - Street 1:600 MAMARONECK AVE STE 400
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:NY
Practice Address - Zip Code:10528-1613
Practice Address - Country:US
Practice Address - Phone:575-520-6074
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-25
Last Update Date:2025-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician