MEDICARE: BEN THOMPSON LMFT PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist

General Provider Information

NPI Number	:	1215543806
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEN THOMPSON LMFT PLLC

Provider Business Mailing Address
First Line	:	2916 GETTYSBURG RD
Second Line	:
City	:	EDMOND
State	:	OK
Zip	:	73013-6458
Country	:	US
Telephone Number	:	405-693-8118
Fax Number	:

Provider Business Practice Location Address
First Line	:	11209 N MAY AVE STE B
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73120-6351
Country	:	US
Telephone Number	:	405-693-8118
Fax Number	:	405-563-7530

Authorized Official
Title or Position	:	OWNER
Name	:	BENJAMIN A THOMPSON
Credential	:	LMFT
Telephone Number	:	405-693-8118

Provider Enumeration Date	:	09/18/2020
Last Update Date	:	09/18/2020

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