Provider Demographics
NPI:1669731006
Name:KATHRYN ASHA THUMME & ASSOCIATES LLC
Entity type:Organization
Organization Name:KATHRYN ASHA THUMME & ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:ASHA
Authorized Official - Last Name:THUMME
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT, CST
Authorized Official - Phone:847-682-0290
Mailing Address - Street 1:100 N ATKINSON RD
Mailing Address - Street 2:SUITE 112E
Mailing Address - City:GRAYSLAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60030-7801
Mailing Address - Country:US
Mailing Address - Phone:847-682-0290
Mailing Address - Fax:
Practice Address - Street 1:1312 COLONIAL SQ
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60189-8116
Practice Address - Country:US
Practice Address - Phone:630-682-3161
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-04
Last Update Date:2012-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL166.000760106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty