Doctor Name: | THOMAS Z. MAXSON |
NPI Number: | 1104937895 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LMHP, LADC |
License Number: | 551 |
Business Practice Address: | 3720 Avenue A Suite E Kearney, NE - 688478169 |
Business Phone Number: | 3082345644 |
Business Fax Number: | 3082345652 |
Mailing Address: | 3720 Avenue A, Suite E KEARNEY |
State: | NE |
Postal Code: | 688478169 |
Phone Number: | 3082345644 |
Fax Number: | 3082345652 |
NPI Enumeration Date: | 08/31/2006 |
NPI Last Update Date: | 12/05/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 551 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NE |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |