Provider Demographics
NPI:1023332244
Name:THOMPSON, MADRICAL LYNN (LPC)
Entity type:Individual
Prefix:
First Name:MADRICAL
Middle Name:LYNN
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 ARGYLE RD
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20901-3202
Mailing Address - Country:US
Mailing Address - Phone:571-225-8386
Mailing Address - Fax:301-587-4107
Practice Address - Street 1:3022 JAVIER RD STE 215
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-4646
Practice Address - Country:US
Practice Address - Phone:571-225-8386
Practice Address - Fax:301-587-4107
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-17
Last Update Date:2010-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701004703101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health