Provider Demographics
NPI:1740172550
Name:DUBBELS, THOMAS KENNETH (MS, LPC)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:KENNETH
Last Name:DUBBELS
Suffix:
Gender:M
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:1051 50TH AVE W
Mailing Address - Street 2:
Mailing Address - City:WEST FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58078-7213
Mailing Address - Country:US
Mailing Address - Phone:701-388-6194
Mailing Address - Fax:701-450-0457
Practice Address - Street 1:4357 13TH AVE S STE 104
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-7504
Practice Address - Country:US
Practice Address - Phone:701-306-8369
Practice Address - Fax:701-450-0457
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-16
Last Update Date:2025-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND819-1-15-15101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health