Thea Wooten, MA, LCASA

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

23390 Issued in NC

Practice address

612 Signal Hill Drive Ext
Statesville, NC 28625-4353

Phone

(704) 872-0234

NPI assigned

Mar 9, 2017

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

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.

• Addiction Recovery Medical Services

  • Community/Behavioral Health Agency
  • Statesville, NC
  • NPI 1487887949

  Addiction (Substance Use Disorder)

  NPD (past)
• Shah Anuj MD PC

  • Interventional Cardiology Physician
  • Passaic, NJ
  • NPI 1215445127
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1489017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489017600000",
    "number": "1083155154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20014 NORTHPORT DR",
            "city": "CORNELIUS",
            "state": "NC",
            "postal_code": "280316433",
            "telephone_number": "704-872-0234",
            "fax_number": "704-818-1114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 SIGNAL HILL DRIVE EXT",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286254353",
            "telephone_number": "704-872-0234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOTEN",
        "first_name": "THEA",
        "credential": "MA, LCASA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-09",
        "last_updated": "2017-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "23390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shawn Nicholas Wolff, DDS
• Jessica Daniels Wood, FNP
• Kimberly Shores Woods, FNP-C
• Michelle H Woods, PA-C
• Angela Robin Wyatt Wooten, LCMHC, NCC
• Whittney Marchelle Work, FNP-C
• Corey A Wright, PHARMD
• Elizabeth Ann Wright, MD
• Emily Wright, CRNA
• Stephanie Wright

• Addiction (Substance Use Disorder) Counselor in Statesville, NC
• Providers in Statesville, NC by specialty
• Addiction (Substance Use Disorder) Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.