Healthcare Provider Details

I. General information

NPI: 1699157073
Provider Name (Legal Business Name): ABOUND COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2015
Last Update Date: 06/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3911 20TH AVE S
FARGO ND
58103-4719
US

IV. Provider business mailing address

PO BOX 389
FARGO ND
58107-0389
US

V. Phone/Fax

Practice location:
  • Phone: 701-271-3272
  • Fax:
Mailing address:
  • Phone: 701-271-3272
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: JESSICA THOMASSON
Title or Position: CEO
Credential:
Phone: 701-271-3272