Ty Thompson, L.A.C.

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

1779 Issued in ND

Practice address

304 7TH St N
New Town, ND 58763

Phone

(701) 627-4700

NPI assigned

Sep 1, 2016

Last updated

Sep 1, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Circle of Life Recovery Center

  • Addiction (Substance Use Disorder) Counselor
  • New Town, ND
  • NPI 1477786051
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1472688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472688000000",
    "number": "1619423308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 FRONTAGE RD",
            "city": "NEW TOWN",
            "state": "ND",
            "postal_code": "587639404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 7TH ST N",
            "city": "NEW TOWN",
            "state": "ND",
            "postal_code": "58763",
            "telephone_number": "701-627-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "TY",
        "credential": "L.A.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-09-01",
        "last_updated": "2016-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "ND",
            "license": "1779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Arne Leroy Sorenson, RD, LN, CDE
• Shelby Stein, RDN
• Cynthia Tamia
• Cody Telsrow, RN
• The Evangelical Lutheran Good Samaritan Society (Good Samaritan Society - New Town)
• Anna Thongphet, LPN
• Jamie Thongphet, FNP-BC
• Three Affiliated Tribes (Minne-Tohe Health Center)
• Three Affiliated Tribes CHR Program
• Three Affiliated Tribes Dialysis Unit

• Addiction (Substance Use Disorder) Counselor in New Town, ND
• Providers in New Town, ND by specialty
• Addiction (Substance Use Disorder) Counselor in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.