Organization
ABUNDANT LIFE FAMILY THERAPY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JESSE DAVID THOMPSON LMFT, SAP (OWNER)
(405) 313-8452
Entity
Organization
Contact information
Practice address
10316 GREENBRIAR PL STE 1, OKLAHOMA CITY, OK 73159-7649
(405) 313-8452
(844) 272-6181
Mailing address
10316 GREENBRIAR PL STE 1, OKLAHOMA CITY, OK 73159-7649
(405) 313-8452
(844) 272-6181
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1104165174
—
OK
05
—
1710299250
—
OK
Enumeration date
07/14/2017
Last updated
07/21/2022
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