Provider Demographics
NPI:1992861777
Name:THOMAS, MERRIUL WELDIN (LMHP, CPC)
Entity type:Individual
Prefix:
First Name:MERRIUL
Middle Name:WELDIN
Last Name:THOMAS
Suffix:
Gender:F
Credentials:LMHP, CPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 744
Mailing Address - Street 2:
Mailing Address - City:MCCOOK
Mailing Address - State:NE
Mailing Address - Zip Code:69001-0744
Mailing Address - Country:US
Mailing Address - Phone:308-345-4676
Mailing Address - Fax:308-345-4676
Practice Address - Street 1:207 W. 2ND,
Practice Address - Street 2:POB 744
Practice Address - City:MCCOOK
Practice Address - State:NE
Practice Address - Zip Code:69001-0744
Practice Address - Country:US
Practice Address - Phone:308-345-4676
Practice Address - Fax:308-345-4676
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2568101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE85451OtherBLUECROSS BLUESHIEL
NE346012000OtherMIS#, MAGELLAN
NE470845408-26Medicaid