Provider Demographics
NPI:1295888048
Name:THOMSEN, TARA LEIGH (LIMHP, CPC)
Entity type:Individual
Prefix:MS
First Name:TARA
Middle Name:LEIGH
Last Name:THOMSEN
Suffix:
Gender:
Credentials:LIMHP, CPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11060 OAK ST # 2
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68144-4826
Mailing Address - Country:US
Mailing Address - Phone:402-933-8988
Mailing Address - Fax:402-933-9091
Practice Address - Street 1:11060 OAK ST # 2
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68144-4826
Practice Address - Country:US
Practice Address - Phone:402-933-8988
Practice Address - Fax:402-933-9091
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1310101YM0800X
NE101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
1376916023OtherGROUP NPI
NE10025293600Medicaid