Individual
THOMPSON SIVERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCPC
Contact information
Practice address
10792 W OVERLAND RD, BOISE, ID 83709-1329
(208) 375-7777
(208) 323-9070
Mailing address
10792 W OVERLAND RD, BOISE, ID 83709-1329
(208) 375-7777
(208) 323-9070
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LCPC157
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010017011
REGENCE BLUE SHIELD
ID
01
—
Q4392
BLUE CROSS OF IDAHO
ID
Enumeration date
01/17/2007
Last updated
07/08/2007
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