Healthcare Provider Details

I. General information

NPI: 1134209133
Provider Name (Legal Business Name): THOMAS POSNANSKI LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/16/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2620 LEBANON AVE
BELLEVILLE IL
62221-3233
US

IV. Provider business mailing address

2620 LEBANON AVE
BELLEVILLE IL
62221-3233
US

V. Phone/Fax

Practice location:
  • Phone: 618-235-9563
  • Fax: 618-235-7115
Mailing address:
  • Phone: 618-235-9563
  • Fax: 618-235-7115

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: