Individual provider Active NPI

Rebecca Elizabeth Thieman, LCSW, CSOTP

  • Clinical Social Worker
  • Louisville, KY
National Provider Identifier
1124611660
Registry record updated May 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904012596 Issued in VA
Practice address
813 Huntington Rd
Louisville, KY 40207-3671
Phone
(804) 767-7540
NPI assigned
Feb 16, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 26, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 0904012596 VA Primary

Addresses

Primary practice location

813 Huntington Rd
Louisville, KY 40207-3671

Mailing address

813 Huntington Rd
Louisville, KY 40207-3671
Phone (804) 767-1005

Other practice location 1

11815 Fountain Way Ste 300
Newport News, VA 23606-4448
Phone (703) 718-6744

Other practice location 2

211 N Union St Ste 100
Alexandria, VA 22314-2643
Phone (703) 718-6744

Other practice location 3

2222 Monument Ave
Suite 1st Floor
Richmond, VA 23220-2724
Phone (804) 372-5749

Other names 1

  • Rebecca Elizabeth Lundell Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0904012596VAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1613433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779753600000",
    "number": "1124611660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "813 HUNTINGTON RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402073671",
            "telephone_number": "804-767-1005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "813 HUNTINGTON RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402073671",
            "telephone_number": "804-767-7540"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11815 Fountain Way Ste 300",
            "address_purpose": "LOCATION",
            "city": "Newport News",
            "state": "VA",
            "postal_code": "236064448",
            "country_code": "US",
            "telephone_number": "703-718-6744",
            "fax_number": "877-447-1027",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "211 N Union St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Alexandria",
            "state": "VA",
            "postal_code": "223142643",
            "country_code": "US",
            "telephone_number": "703-718-6744",
            "fax_number": "877-447-1027",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2222 Monument Ave",
            "address_2": "Suite 1st Floor",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "VA",
            "postal_code": "232202724",
            "country_code": "US",
            "telephone_number": "804-372-5749",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THIEMAN",
        "first_name": "REBECCA",
        "middle_name": "ELIZABETH",
        "credential": "LCSW, CSOTP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-16",
        "last_updated": "2026-05-26",
        "certification_date": "2026-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904012596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "LUNDELL",
            "middle_name": "ELIZABETH",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2026; 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.