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NPI Code Detail

MEDICARE: MS. ROSEMARY NELLE THOMASSON LMFT

MEDICARE: MS. ROSEMARY NELLE THOMASSON LMFT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) CounselorLCAC317KS
2101YM0800XMental Health CounselorLCMFT712KS

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1265627343
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ROSEMARY NELLE THOMASSON LMFT
Provider Business Mailing Address
First Line : 1319 W MAY ST
Second Line :
City : WICHITA
State : KS
Zip : 67213-3505
Country : US
Telephone Number : 316-267-2030
Fax Number : 316-267-2007
Provider Business Practice Location Address
First Line : 1319 W MAY ST
Second Line :
City : WICHITA
State : KS
Zip : 67213-3505
Country : US
Telephone Number : 316-267-2030
Fax Number : 316-267-2007
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/11/2007
Last Update Date : 02/04/2015

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