Provider Demographics
NPI:1164979233
Name:ST. THOMAS COUNSELING CENTER, PLLC
Entity Type:Organization
Organization Name:ST. THOMAS COUNSELING CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO.LICENSED CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:STACEY
Authorized Official - Middle Name:
Authorized Official - Last Name:HUNT
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:701-269-0765
Mailing Address - Street 1:1613 15TH ST SW
Mailing Address - Street 2:
Mailing Address - City:JAMESTOWN
Mailing Address - State:ND
Mailing Address - Zip Code:58401-5034
Mailing Address - Country:US
Mailing Address - Phone:701-269-0765
Mailing Address - Fax:
Practice Address - Street 1:108 1ST AVE S # 5
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:ND
Practice Address - Zip Code:58401-4101
Practice Address - Country:US
Practice Address - Phone:701-269-0765
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-07
Last Update Date:2016-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND484251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health