Latrese Thompson, M.S., LPCC, CRC

Primary specialty

CounselorTaxonomy code 101Y00000X

License

1415 Issued in CA

Practice address

4376 Elm St
San Diego, CA 92105-5221

Phone

(301) 818-3090

NPI assigned

Sep 28, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1695859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695859200000",
    "number": "1619756533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4002 FOX GATE LN",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207729357",
            "telephone_number": "301-818-3090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4376 ELM ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921055221",
            "telephone_number": "301-818-3090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "LATRESE",
        "name_prefix": "Ms.",
        "credential": "M.S., LPCC, CRC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-28",
        "last_updated": "2023-09-28",
        "certification_date": "2023-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "CA",
            "license": "1415",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "1415",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CA",
            "license": "1415",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225C00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Counselor",
            "state": "FL",
            "license": "00111574",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kerry Ray Thompson, PHYSICAL THERAPIST
• Khalea Aiko Thompson
• Kimberley Thompson, LCS
• Kimberly Ann Thompson, MD
• Kyle Mark Thompson, M.D.
• Leslie Cross Thompson, NP
• Lori Michele Thompson, NNP
• Marilyn Thompson, MFT
• Marissa Thompson
• Matthew Michael Thompson, D.O.

• Counselor in San Diego, CA
• Providers in San Diego, CA by specialty
• Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2023; 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.