Provider Demographics
NPI:1235726225
Name:THRAMER, MANON ELAINE (MSE, LMHP, NSS)
Entity Type:Individual
Prefix:
First Name:MANON
Middle Name:ELAINE
Last Name:THRAMER
Suffix:
Gender:F
Credentials:MSE, LMHP, NSS
Other - Prefix:
Other - First Name:MANON
Other - Middle Name:ELAINE
Other - Last Name:THRAMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:505 142ND ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH SIOUX CITY
Mailing Address - State:NE
Mailing Address - Zip Code:68776-4500
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:505 142ND ST
Practice Address - Street 2:
Practice Address - City:SOUTH SIOUX CITY
Practice Address - State:NE
Practice Address - Zip Code:68776-4500
Practice Address - Country:US
Practice Address - Phone:712-223-5801
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-24
Last Update Date:2020-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2264101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health