MS. KRISTINE A. THELEN (NPI# 1407855414) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407855414 |
| Entity Type | Individual |
| Full Name | MS. KRISTINE A. THELEN |
| Other Name | MRS. KRISTINE ANN THELEN-EBERHART |
| Credential | LCSW |
| Practice Address |
108 N Main St Suite 305 South Bend IN 46601-1625 |
| Mailing Address |
4209 Cross Creek Dr South Bend IN 46628 |
| Practice Telephone | 5742343515 |
| Practice Fax Number | 5742343565 |
| Mailing Telephone | 5742612488 |
| Mailing Fax Number | 5742343565 |
| Enumeration Date | 2005-07-20 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | 34004344A | IN | Behavioral Health & Social Service Providers |
| Street Address |
108 N MAIN ST SUITE 305 |
| City | SOUTH BEND |
| State | IN |
| Zip Code | 46601-1625 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588986327 | Sironaj Hindawi | Counselor | 108 N Main St, South Bend, IN 46601-1625 | 2010-02-22 |
| 1538494687 | Deanna J Saylor | Counselor | 108 N Main St, Suite 200, South Bend, IN 46601-1625 | 2009-10-07 |
| 1932340718 | Angela B Mills | Social Worker | 108 N Main St, Suite 200, South Bend, IN 46601-1625 | 2009-03-09 |
| 1376783555 | Idah Gudyanga | Social Worker | 108 N Main St, Suite 305, South Bend, IN 46601-1625 | 2009-02-27 |
| 1548409188 | Frances Marie Touhey | Counselor | 108 N Main St, Suite 305, South Bend, IN 46601-1625 | 2009-02-04 |
| 1265689582 | Antoinette Redding | Counselor | 108 N Main St, South Bend, IN 46601-1625 | 2008-08-19 |
| 1457521502 | Marjorie S Zeitler | Counselor | 108 N Main St, Suite 305, South Bend, IN 46601-1625 | 2008-03-05 |
| 1447435755 | Shotunus Denean Peterson | Social Worker | 108 N Main St, Suite 305, South Bend, IN 46601-1625 | 2008-01-04 |
| 1265626386 | Renee Louise Derosa | Social Worker | 108 N Main St, Suite # 305, South Bend, IN 46601-1625 | 2007-08-31 |
| 1023213790 | Tricia L Wainscott | Social Worker | 108 N Main St, South Bend, IN 46601-1625 | 2007-06-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447610449 | David Thomas | Hearing Instrument Specialist | 808 S Michigan St., South Bend, IN 46601 | 2016-03-03 |
| 1285072454 | Kevin Francis Cumper | Internal Medicine | 621 Memorial Dr Ste 624, South Bend, IN 46601 | 2013-06-11 |
| 1952605560 | Robert Lusk Bonham | Dentist | 1222 L.w.e., So. Bend, IN 46601 | 2010-12-23 |
| 1649580911 | Daniel Scott Debrule | Psychologist | 211 W. Washington Street, Suite 2311, South Bend, IN 46601 | 2010-10-20 |
| 1528390770 | Luke Alfred White | Internal Medicine | 615 N. Michigan St., Memorial Hospital, C/o Erin Smith, South Bend, IN 46601 | 2010-02-12 |
| 1548497837 | Tmg Home Health Care | Home Health | 108 N Main St #305, South Bend, IN 46601 | 2009-06-15 |
| 1225283039 | Jody L. Hughes | Counselor | 202 S. Michigan Street, Suite 875, South Bend, IN 46601 | 2008-11-20 |
| 1740432574 | Amanda Jayne Quicksall | Social Worker | 611 Lincolnway W, South Bend, IN 46601 | 2008-10-10 |
| 1952565772 | Thomas P Judd | Dentist | 1901 #b Western Avenue, Ihc South Bend, South Bend, IN 46601 | 2008-07-10 |
| 1851590269 | Warren Larry Penrod | Nurse Practitioner | 333 W. Western Ave, South Bend, IN 46601 | 2007-07-16 |
| Find all providers in zip 46601 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770191892 | Baochun Hind | Counselor | 1205 E Bronson St, South Bend, IN 46615-1141 | 2020-07-15 |
| 1356820765 | Roniqua Teshae Roundtree | Counselor | 53174 Flowing Stream Ct, South Bend, IN 46628-9034 | 2018-08-08 |
| 1760909840 | Precious Pals Inc | Counselor | 1139 E Lasalle Ave, South Bend, IN 46617-3321 | 2017-08-29 |
| 1780053546 | Jonathan Rosengren | Counselor | 415 E Madison Street, South Bend, IN 46617-1109 | 2015-09-22 |
| 1225283039 | Jody L. Hughes | Counselor | 202 S. Michigan Street, Suite 875, South Bend, IN 46601 | 2008-11-20 |
| 1063673531 | Madeline Christina Watkins | Counselor | 616 E Colfax, South Bend, IN 46617 | 2008-06-18 |
| 1437289469 | Randy Nims | Counselor | 701 N Niles Ave, South Bend, IN 46617-1923 | 2007-03-07 |
| 1609906593 | Jenifer R Hill | Counselor | 227n Dixie Way 140, South Bend, IN 46637-3300 | 2007-03-07 |
| 1396873147 | Barbara Lynn Miller | Counselor | 5024 W Western Ave, South Bend, IN 46619-2312 | 2007-03-02 |
| 1255472643 | Deborah Kay Clardy | Counselor | 53846 Generations Dr, South Bend, IN 46635-1543 | 2007-02-09 |
| Find all providers in SOUTH BEND | ||||
| City | SOUTH BEND |
| Zip Code | 46601 |
Please comment or provide details below to improve the information on MS. KRISTINE A. THELEN.
| 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.