Active NPI
Ann M Thompson, LPC, CSAC, ICS
- Professional Counselor
- Wausau, WI
National Provider Identifier
1154626034
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 4920-125
- Practice address
- 1532 N 1St Ave
Wausau, WI 54401-2514 - Phone
- (715) 297-0564
- Fax
- (715) 845-1977
- NPI assigned
- Jan 24, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 15470-131 | WI | |
| Professional Counselor | 101YP2500X | 4920-125 | WI | Primary |
Addresses
Primary practice location
1532 N 1St Ave
Wausau, WI 54401-2514
Mailing address
1532 N 1St Ave
Wausau, WI 54401-2514
Phone (715) 297-0564
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4920-125 | Other | WI | STATE LICENSE |
| 15470-131 | Other | WI | LICENSE |
Other names 1
- Ann M Grizzle-Thompson
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
| License | State | Type | Specialty |
|---|---|---|---|
| 15470-131 | WI | MD | Addiction (Substance Use Disorder) Counselor |
| 4920-125 | WI | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1295827200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1613952000000",
"number": "1154626034",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1532 N 1ST AVE",
"city": "WAUSAU",
"state": "WI",
"postal_code": "544012514",
"telephone_number": "715-297-0564",
"fax_number": "715-845-1977"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1532 N 1ST AVE",
"city": "WAUSAU",
"state": "WI",
"postal_code": "544012514",
"telephone_number": "715-297-0564",
"fax_number": "715-845-1977"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THOMPSON",
"first_name": "ANN",
"middle_name": "M",
"credential": "LPC, CSAC, ICS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-01-24",
"last_updated": "2021-02-22",
"certification_date": "2021-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "WI",
"license": "15470-131",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "WI",
"license": "4920-125",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "4920-125",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "15470-131",
"state": "WI"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "ANN",
"last_name": "GRIZZLE-THOMPSON",
"middle_name": "M",
"credential": "LPC, SAC",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Wausau, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.