Provider Demographics
NPI:1265741615
Name:THOMPSON, CLAIRE CONSTANCE (LPC)
Entity type:Individual
Prefix:MRS
First Name:CLAIRE
Middle Name:CONSTANCE
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MRS
Other - First Name:CECE
Other - Middle Name:
Other - Last Name:THOMPSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC
Mailing Address - Street 1:210 E. MAIN ST.
Mailing Address - Street 2:RESOURCE MANAGEMENT
Mailing Address - City:ADA
Mailing Address - State:OK
Mailing Address - Zip Code:74820
Mailing Address - Country:US
Mailing Address - Phone:580-436-7211
Mailing Address - Fax:580-272-5757
Practice Address - Street 1:2510 CHICKASAW BLVD.
Practice Address - Street 2:MEDICAL FAMILY THERAPY
Practice Address - City:ARDMORE
Practice Address - State:OK
Practice Address - Zip Code:73401
Practice Address - Country:US
Practice Address - Phone:580-226-8181
Practice Address - Fax:580-421-6283
Is Sole Proprietor?:No
Enumeration Date:2010-10-04
Last Update Date:2017-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3604101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK3604OtherLICENSE