Provider Demographics
NPI:1255634531
Name:THURMAN PSYCHOLOGICAL LLC
Entity type:Organization
Organization Name:THURMAN PSYCHOLOGICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROSANNA
Authorized Official - Middle Name:M
Authorized Official - Last Name:JONES-THURMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-715-4321
Mailing Address - Street 1:6818 GROVER ST.
Mailing Address - Street 2:SUITE 305
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68106
Mailing Address - Country:US
Mailing Address - Phone:402-715-4321
Mailing Address - Fax:402-715-4343
Practice Address - Street 1:6818 GROVER ST.
Practice Address - Street 2:STE. 305
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68106
Practice Address - Country:US
Practice Address - Phone:402-715-4321
Practice Address - Fax:402-715-4343
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-08
Last Update Date:2013-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE539103TC0700X
103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty