Provider Demographics
NPI:1942327903
Name:THIRLKEL, THOMAS EDMUND
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:EDMUND
Last Name:THIRLKEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8645 COLLEGE BLVD
Mailing Address - Street 2:220
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66210-1835
Mailing Address - Country:US
Mailing Address - Phone:816-914-3057
Mailing Address - Fax:913-341-8125
Practice Address - Street 1:8645 COLLEGE BLVD
Practice Address - Street 2:220
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66210-1835
Practice Address - Country:US
Practice Address - Phone:816-914-3057
Practice Address - Fax:913-341-8125
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS10631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical