Healthcare Provider Details

I. General information

NPI: 1982859542
Provider Name (Legal Business Name): RICHARD THOMAS, PHD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/24/2008
Last Update Date: 11/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6920 VAN DORN ST STE B
LINCOLN NE
68506-2977
US

IV. Provider business mailing address

1928 HIGH ST
LINCOLN NE
68502-4825
US

V. Phone/Fax

Practice location:
  • Phone: 402-476-7557
  • Fax: 402-476-9912
Mailing address:
  • Phone: 402-309-4667
  • Fax: 402-476-9912

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number402
License Number StateNE

VIII. Authorized Official

Name: DR. RICHARD N. THOMAS
Title or Position: LICENSED PSYCHOLOGIST
Credential: PHD
Phone: 402-309-4667