| Doctor Name: | MARK THOMPSON |
| NPI Number: | 1144266990 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LPC |
| License Number: | 14567 |
| Business Practice Address: | 2300 Highway 365 Suite 620 Nederland, TX - 776276256 |
| Business Phone Number: | 4097290400 |
| Business Fax Number: | 4097290401 |
| Mailing Address: | 2300 Highway 365, Suite 620 NEDERLAND |
| State: | TX |
| Postal Code: | 776276256 |
| Phone Number: | 4097290400 |
| Fax Number: | 4097290401 |
| NPI Enumeration Date: | 06/21/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 14567 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |