Individual
LEISHA THOMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, LCADC, CJC
Contact information
Practice address
445 BRICK BLVD STE 304, BRICK, NJ 08723-6080
(732) 814-3399
(732) 785-9500
Mailing address
294 SPRUCE DR, BRICK, NJ 08723-5946
(732) 477-7849
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
37PC00306300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0029807
—
NJ
Enumeration date
12/20/2006
Last updated
04/30/2024
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