Provider Demographics
NPI:1134209133
Name:POSNANSKI, THOMAS (LMFT)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:
Last Name:POSNANSKI
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2620 LEBANON AVE
Mailing Address - Street 2:
Mailing Address - City:BELLEVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62221-3233
Mailing Address - Country:US
Mailing Address - Phone:618-235-9563
Mailing Address - Fax:618-235-7115
Practice Address - Street 1:2620 LEBANON AVE
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:IL
Practice Address - Zip Code:62221-3233
Practice Address - Country:US
Practice Address - Phone:618-235-9563
Practice Address - Fax:618-235-7115
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL08232125OtherBCBS