Provider Demographics
NPI:1952938656
Name:THURMAN, GLORIA FOSTER (MA, LCMHC, NCC)
Entity Type:Individual
Prefix:
First Name:GLORIA
Middle Name:FOSTER
Last Name:THURMAN
Suffix:
Gender:F
Credentials:MA, LCMHC, NCC
Other - Prefix:
Other - First Name:GLORIA
Other - Middle Name:FOSTER
Other - Last Name:THURMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA, LCMHC, NCC
Mailing Address - Street 1:135 NORMANDY RD
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117-8430
Mailing Address - Country:US
Mailing Address - Phone:980-521-6713
Mailing Address - Fax:
Practice Address - Street 1:444 WILLIAMSON RD STE E
Practice Address - Street 2:
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28117-9248
Practice Address - Country:US
Practice Address - Phone:980-521-6713
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-24
Last Update Date:2020-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12210101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional