Individual
DR. THOMAS JEFFERSON POUNDERS III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW, MDIV, PHD
Contact information
Practice address
1011 HONOR HEIGHTS DR, MAIL CODE 115, MUSKOGEE, OK 74401-1318
(918) 577-3000
(918) 577-3648
Mailing address
4421 W OKMULGEE ST # 328, MUSKOGEE, OK 74401-4651
(580) 320-5287
(918) 577-3701
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LCSW 3620
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CERT CASE MGR 9983
OKLAHOMA DEPARTMENT OF MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES
OK
01
—
LCSW 3620
OKLAHOMA STATE BOARD OF LICENSED SOCIAL WORKERS
OK
Enumeration date
07/11/2007
Last updated
06/03/2009
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