Individual
DERRICK THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2387 LAWRENCEVILLE HUNTCREST WAY, LAWRENCEVILLE, GA 30043
(678) 648-7644
Mailing address
1209 SUMMERCHASE DR, DULUTH, GA 30096-8013
(470) 736-1525
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
BACB570208
GA
106S00000X
Behavior Technician
Primary
BACB570208
NV
Other
Enumeration date
09/30/2020
Last updated
02/17/2026
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