Individual
ERIK CONVERSE THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
047 0000 619
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
078188
OPTIONS
VT
01
—
11467960
CAQH
VT
01
—
28619
BLUE CROSS/BLUE SHIELD
VT
01
—
2904620
CIGNA BH
VT
01
—
41501
MVP
VT
05
—
OVN1286
—
VT
Enumeration date
07/03/2006
Last updated
02/13/2008
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