Provider Demographics
NPI:1023283694
Name:GARRIE B THOMPSON III PHD PA
Entity type:Organization
Organization Name:GARRIE B THOMPSON III PHD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GARRIE
Authorized Official - Middle Name:B
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:III
Authorized Official - Credentials:PHD
Authorized Official - Phone:561-750-9118
Mailing Address - Street 1:1612 ASHEVILLE HWY STE 2
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28791-3466
Mailing Address - Country:US
Mailing Address - Phone:828-595-9531
Mailing Address - Fax:828-595-9431
Practice Address - Street 1:1612 ASHEVILLE HWY STE 2
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28791-3466
Practice Address - Country:US
Practice Address - Phone:828-595-9531
Practice Address - Fax:828-595-9431
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-24
Last Update Date:2025-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY5584103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPY5584OtherFLORIDA LICENSE
FLK1059OtherMEDICARE
S52861Medicare UPIN