| Doctor Name: | JOHN DAVID THOMPSON |
| NPI Number: | 1194070854 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LCSW |
| License Number: | 003062 |
| Business Practice Address: | 501 Mize St La Fayette, GA - 307283346 |
| Business Phone Number: | 7066385580 |
| Business Fax Number: | 7066385445 |
| Mailing Address: | 501 Mize St, LA FAYETTE |
| State: | GA |
| Postal Code: | 307283346 |
| Phone Number: | 7066385580 |
| Fax Number: | 7066385445 |
| NPI Enumeration Date: | 07/18/2012 |
| NPI Last Update Date: | 07/18/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 003062 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |