Provider Demographics
NPI:1215928908
Name:BRENNAN, THOMAS PATRICK (PHD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:PATRICK
Last Name:BRENNAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7441 O ST
Mailing Address - Street 2:SUITE 402
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68510-2468
Mailing Address - Country:US
Mailing Address - Phone:402-483-4215
Mailing Address - Fax:402-483-5228
Practice Address - Street 1:7441 O ST
Practice Address - Street 2:SUITE 402
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510-2468
Practice Address - Country:US
Practice Address - Phone:402-483-4215
Practice Address - Fax:402-483-5228
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-02
Last Update Date:2007-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE180103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling