Healthcare Provider Details

I. General information

NPI: 1578277844
Provider Name (Legal Business Name): URBAN PLAINS COUNSELING AND CONSULTING, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2023
Last Update Date: 02/17/2023
Certification Date: 02/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 N 3RD ST STE 230
BISMARCK ND
58501-3874
US

IV. Provider business mailing address

6300 STAR LN
BISMARCK ND
58503-6735
US

V. Phone/Fax

Practice location:
  • Phone: 701-696-4322
  • Fax: 701-501-6209
Mailing address:
  • Phone: 701-391-1608
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: ANNA THOMPSON
Title or Position: OWNER/LPCC
Credential: LPCC
Phone: 701-696-4322