Individual
CONNIE M THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CASAC-G
Contact information
Practice address
404 STATE ROUTE 37, HOGANSBURG, NY 13655
(518) 358-3141
(518) 358-9175
Mailing address
404 STATE ROUTE 37, HOGANSBURG, NY 13655
(518) 358-3141
(518) 358-9175
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
7733
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7733
CASAC-G
NY
Enumeration date
05/29/2020
Last updated
05/29/2020
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