Provider Demographics
NPI:1265627343
Name:THOMASSON, ROSEMARY NELLE (LMFT)
Entity type:Individual
Prefix:MS
First Name:ROSEMARY
Middle Name:NELLE
Last Name:THOMASSON
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:MS
Other - First Name:ROSEMARY
Other - Middle Name:NELLE
Other - Last Name:THOMASSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCMFT
Mailing Address - Street 1:1319 W MAY ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67213-3505
Mailing Address - Country:US
Mailing Address - Phone:316-267-2030
Mailing Address - Fax:316-267-2007
Practice Address - Street 1:1319 W MAY ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67213-3505
Practice Address - Country:US
Practice Address - Phone:316-267-2030
Practice Address - Fax:316-267-2007
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-11
Last Update Date:2015-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSLCAC317101YA0400X
KSLCMFT712101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200475260AMedicaid