Provider Demographics
NPI:1962915082
Name:THUMMEL-HOWARD, MARCY LYNN (TLMHC)
Entity type:Individual
Prefix:MS
First Name:MARCY
Middle Name:LYNN
Last Name:THUMMEL-HOWARD
Suffix:
Gender:F
Credentials:TLMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1820 N 16TH ST
Mailing Address - Street 2:
Mailing Address - City:CLARINDA
Mailing Address - State:IA
Mailing Address - Zip Code:51632-1165
Mailing Address - Country:US
Mailing Address - Phone:712-542-3103
Mailing Address - Fax:
Practice Address - Street 1:619 SUNSET DR
Practice Address - Street 2:
Practice Address - City:CLARINDA
Practice Address - State:IA
Practice Address - Zip Code:51632-2446
Practice Address - Country:US
Practice Address - Phone:515-975-3151
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-10
Last Update Date:2017-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA078886101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty