Active NPI
Theresa M Normoyle, PHD
- Psychologist
- Chehalis, WA
National Provider Identifier
1023359254
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PY60128025
- Practice address
- 2690 NE Kresky Ave
Chehalis, WA 98532-2412 - Phone
- (360) 330-9595
- Fax
- (360) 330-9560
- NPI assigned
- Mar 13, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | CL60160627 | WA | |
| Mental Health Counselor | 101YM0800X | LH60432436 | WA | |
| Clinical Psychologist | 103TC0700X | PY60128025 | WA | |
| Psychologist | 103T00000X | PY60128025 | WA | Primary |
Addresses
Primary practice location
2690 NE Kresky Ave
Chehalis, WA 98532-2412
Mailing address
2690 NE Kresky Ave
Chehalis, WA 98532-2412
Phone (360) 330-9595
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2040196 | Medicaid | WA |
Other names 1
- Theresa Church
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jul 1, 2025 through Jul 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CL60160627 | WA | MD | Counselor |
| LH60432436 | WA | MD | Mental Health Counselor |
| PY60128025 | WA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1363132800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1482364800000",
"number": "1023359254",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2690 NE KRESKY AVE",
"city": "CHEHALIS",
"state": "WA",
"postal_code": "985322412",
"telephone_number": "360-330-9595",
"fax_number": "360-330-9560"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2690 NE KRESKY AVE",
"city": "CHEHALIS",
"state": "WA",
"postal_code": "985322412",
"telephone_number": "360-330-9595",
"fax_number": "360-330-9560"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NORMOYLE",
"first_name": "THERESA",
"middle_name": "M",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-03-13",
"last_updated": "2016-12-22",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "WA",
"license": "CL60160627",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WA",
"license": "LH60432436",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "WA",
"license": "PY60128025",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "WA",
"license": "PY60128025",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2040196",
"state": "WA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "THERESA",
"last_name": "CHURCH",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Chehalis, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.