Provider Demographics
NPI:1376878256
Name:THURMAN, THOMAS (MSW, CSSW, CSW)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:
Last Name:THURMAN
Suffix:
Gender:M
Credentials:MSW, CSSW, CSW
Other - Prefix:MR
Other - First Name:THOMAS
Other - Middle Name:
Other - Last Name:THURMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW,CSSW, CSW
Mailing Address - Street 1:20303 KELLY RD
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48225-1206
Mailing Address - Country:US
Mailing Address - Phone:313-245-7000
Mailing Address - Fax:313-245-7009
Practice Address - Street 1:20303 KELLY RD.
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48225
Practice Address - Country:US
Practice Address - Phone:313-245-7000
Practice Address - Fax:313-245-7009
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-09
Last Update Date:2009-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010715371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical