Thea CS Hunter, CSAC, LPC, ICS

Key facts

NPI

1083045801

Entity type

Individual (NPI type 1)

Primary specialty

Professional Counselor 101YP2500X

License

7854 (WI)

Practice address

5355 Root River Dr
Greendale, WI 53129-2829

Phone

(262) 914-9787

NPI assigned

Dec 4, 2013

Sex

Female

Sole proprietor

Yes

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Columbia St. Mary'S Hospital Milwaukee, Inc Multi-Specialty Clinic/Center · Milwaukee, WI · NPI 1023064482
  Medicare reassignment NPD WI
• Columbia St. Mary'S Hospital Milwaukee Inc Psychiatric Hospital Unit · Mequon, WI · NPI 1417600909
  NPD

Medicare participation

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

State licenses

Practice roles

Locations

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Oct 4, 2024.

{
    "created_epoch": "1386115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728000000000",
    "number": "1083045801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5355 ROOT RIVER DR",
            "city": "GREENDALE",
            "state": "WI",
            "postal_code": "531292829",
            "telephone_number": "262-914-9787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5355 ROOT RIVER DR",
            "city": "GREENDALE",
            "state": "WI",
            "postal_code": "531292829",
            "telephone_number": "262-914-9787"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "N112W15415 Mequon Rd",
            "address_purpose": "LOCATION",
            "city": "Germantown",
            "state": "WI",
            "postal_code": "530223410",
            "country_code": "US",
            "telephone_number": "262-250-7800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUNTER",
        "first_name": "THEA",
        "middle_name": "CS",
        "name_prefix": "Ms.",
        "credential": "CSAC, LPC, ICS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-12-04",
        "last_updated": "2024-10-04",
        "certification_date": "2024-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "16187",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "7854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Greendale, WI · Professional Counselor in Wisconsin