Healthcare Provider Details

I. General information

NPI: 1396601795
Provider Name (Legal Business Name): ARIADNE THOMPSON FAMILY COUNSELING SERVICES PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2025
Last Update Date: 12/29/2025
Certification Date: 12/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2428 DWIGHT WAY STE 1
BERKELEY CA
94704-3503
US

IV. Provider business mailing address

2428 DWIGHT WAY STE 1
BERKELEY CA
94704-3503
US

V. Phone/Fax

Practice location:
  • Phone: 415-513-7769
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: ARIADNE THOMPSON
Title or Position: CEO
Credential:
Phone: 415-513-7769