Provider Demographics
NPI:1659025526
Name:THOMPSON, NATASHA MARIE (LMSW)
Entity Type:Individual
Prefix:
First Name:NATASHA
Middle Name:MARIE
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31856 MEADOW PL
Mailing Address - Street 2:
Mailing Address - City:MANNFORD
Mailing Address - State:OK
Mailing Address - Zip Code:74044-3426
Mailing Address - Country:US
Mailing Address - Phone:918-549-0317
Mailing Address - Fax:
Practice Address - Street 1:3712 E 11TH ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74112-3952
Practice Address - Country:US
Practice Address - Phone:918-834-4194
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-09
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health