Individual provider Active NPI

Rebecca Lynn Thompson, PHD, BCBA-D

  • Clinical Psychologist
  • Brookfield, WI
National Provider Identifier
1568784114
Registry record updated Nov 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
2916-57 Issued in WI
Practice address
150 N Sunny Slope Rd
Suite #100
Brookfield, WI 53005-4806
Phone
(262) 432-5660
Fax
(262) 432-5666
NPI assigned
Feb 24, 2010
Last updated
Nov 18, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 2916-57 WI Primary
Behavior Analyst 103K00000X 59-140 WI

Addresses

Primary practice location

150 N Sunny Slope Rd
Suite #100
Brookfield, WI 53005-4806

Mailing address

150 N Sunny Slope Rd
Suite #100
Brookfield, WI 53005-4806
Phone (262) 432-5660

Other identifiers 1

IdentifierTypeStateIssuer
1568784114MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
59-140WIMDBehavioral Analyst
2916-57WIMDClinical Psychologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1266969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447804800000",
    "number": "1568784114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 N SUNNY SLOPE RD",
            "address_2": "SUITE #100",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530054806",
            "telephone_number": "262-432-5660",
            "fax_number": "262-432-5666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 N SUNNY SLOPE RD",
            "address_2": "SUITE #100",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530054806",
            "telephone_number": "262-432-5660",
            "fax_number": "262-432-5666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "REBECCA",
        "middle_name": "LYNN",
        "credential": "PHD, BCBA-D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-24",
        "last_updated": "2015-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WI",
            "license": "2916-57",
            "primary": true
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "WI",
            "license": "59-140",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1568784114",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookfield, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.