Provider Demographics
NPI:1801808472
Name:THOMPSON, WILLIAM GLENN (LPC)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:GLENN
Last Name:THOMPSON
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:MR
Other - First Name:WILLIAM
Other - Middle Name:GLENN
Other - Last Name:THOMPSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:4005 SPICEWOOD SPRINGS RD
Mailing Address - Street 2:BUILDING B, SUITE 400
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-8666
Mailing Address - Country:US
Mailing Address - Phone:512-338-1171
Mailing Address - Fax:
Practice Address - Street 1:4005 SPICEWOOD SPRINGS RD
Practice Address - Street 2:BUILDING B, SUITE 400
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-8666
Practice Address - Country:US
Practice Address - Phone:512-338-1171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17395101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional