THEA WOOTEN (NPI# 1083155154) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083155154 |
| Entity Type | Individual |
| Full Name | THEA WOOTEN |
| Credential | MA, LCASA |
| Practice Address |
612 Signal Hill Drive Ext Statesville NC 28625-4353 |
| Mailing Address |
20014 Northport Dr Cornelius NC 28031-6433 |
| Practice Telephone | 7048720234 |
| Mailing Telephone | 7048720234 |
| Mailing Fax Number | 7048181114 |
| Enumeration Date | 2017-03-09 |
| Last Update Date | 2017-03-09 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
23390 | NC | Behavioral Health & Social Service Providers |
| Street Address |
612 SIGNAL HILL DRIVE EXT |
| City | STATESVILLE |
| State | NC |
| Zip Code | 28625-4353 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730714163 | Sandra Lourdes Mayta | Counselor | 1450 Fern Creek Drive, Statesville, NC 28625 | 2020-03-05 |
| 1023643582 | Youngchi Chang Dds Pllc | Dentist | 964 Glenway Ave Ste A, Statesville, NC 28625 | 2020-03-05 |
| 1538799200 | Nicole-marie Blischak | Dentist | 964 Glenway Dr, Ste A, Statesville, NC 28625 | 2020-01-22 |
| 1013575257 | Sherry Neilson | Registered Nurse | 524 Signal Hill Rd, Statesville, NC 28625 | 2019-06-03 |
| 1770904328 | Elinor Kyle Tyner | Counselor | 1206 Museum Road, Statesville, NC 28625 | 2013-12-30 |
| 1982031001 | Tamiko Bradley | Counselor | 524 Signal Hill Dr Ext, Statesville, NC 28625 | 2013-10-03 |
| 1487932505 | Nicole Weisner Winecoff | Advanced Practice Midwife | 1420 Fern Creek Drive, Statesville, NC 28625 | 2011-07-22 |
| 1538461967 | Bethany J Sprague | Nurse Practitioner | 2632 Fines Creek Dr, Statesville, NC 28625 | 2010-11-17 |
| 1477789147 | Greenbriar Primary Care, Pa | Nurse Practitioner | 308-c Mocksville Highway, Statesville, NC 28625 | 2009-06-08 |
| 1619122538 | Phasebdevelopment | Substance Abuse Rehabilitation Facility | 113 Bethany Rd, Statesville, NC 28625 | 2008-11-19 |
| Find all providers in zip 28625 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417368135 | Edward Curlee | Counselor | 211 S Center St Ste 419, Statesville, NC 28677-5873 | 2014-05-15 |
| 1104163625 | Shadese Lisa Griffith-mcclellan | Counselor | 1033 Phillips Ln, Statesville, NC 28625-4747 | 2013-01-04 |
| 1033393699 | James Michael Baker | Counselor | 318 Turnersburg Hwy # 21, Statesville, NC 28625-2798 | 2007-12-19 |
| 1669690186 | Kevin Raymond Denny | Counselor | 119 W Water St Ste C, Statesville, NC 28677-5282 | 2007-04-22 |
| 1043236847 | Erin Langdon Mcadams | Counselor | 636 Signal Hill Drive Ext, Statesville, NC 28625-4774 | 2006-07-14 |
| 1083221758 | Lyricist Dior Cotton | Counselor | 636 Signal Hill Drive Ext, Statesville, NC 28625-4774 | 2020-09-28 |
| 1396377057 | Paula D Gabriel | Counselor | 536 Signal Hill Drive Ext, Statesville, NC 28625-4391 | 2020-02-10 |
| 1376194191 | Anna Hines | Counselor | 518 Signal Hill Drive Ext, Statesville, NC 28625-4391 | 2019-09-23 |
| 1457900557 | Deborah Anne Kurtz | Counselor | 536 Signal Hill Drive Ext, Statesville, NC 28625-4391 | 2019-09-11 |
| 1841849601 | Jennifer Leigh Crow | Counselor | 536 Signal Hill Drive Ext, Statesville, NC 28625-4391 | 2019-09-05 |
| Find all providers in STATESVILLE | ||||
| City | STATESVILLE |
| Zip Code | 28625 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.