Individual
MR. MICHAEL GREGORY THOMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCPC , CRADC , SAP
Contact information
Practice address
4230 LINCOLNSHIRE DR, SUITE E, MOUNT VERNON, IL 62864-2189
(618) 242-4290
(618) 242-4209
Mailing address
4230 LINCOLNSHIRE DR, SUITE E, MOUNT VERNON, IL 62864-2189
(618) 242-4290
(618) 242-4209
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
IL
101YP2500X
Professional Counselor
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04128084
BLUE CROSS BLUE SHIELD
IL
01
—
5266705
AETNA
IL
Enumeration date
08/30/2006
Last updated
09/11/2025
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