Provider Demographics
NPI:1841416393
Name:ROOK-THOMAS, SUSAN PATRICIA (LMFT)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:PATRICIA
Last Name:ROOK-THOMAS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 5TH AVE
Mailing Address - Street 2:STE # 3
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94901-6104
Mailing Address - Country:US
Mailing Address - Phone:510-647-8108
Mailing Address - Fax:510-647-8108
Practice Address - Street 1:1000 5TH AVE
Practice Address - Street 2:STE # 3
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94901-6104
Practice Address - Country:US
Practice Address - Phone:510-647-8108
Practice Address - Fax:510-647-8108
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA41210106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist