Thea Kaitlynne Bohannon, MS, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

008393 Issued in NY

Practice address

3 Bridge St
Carthage, NY 13619-1360

Phone

(315) 493-3300

Fax

(315) 493-3306

NPI assigned

Jul 13, 2015

Last updated

May 4, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tdruant@cahclinics.medentdirect.com

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

• Carthage Area Hospital Inc

  • Critical Access Hospital
  • Carthage, NY
  • NPI 1053497388
  Medicare reassignment NPD
• Carthage Area Hospital Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Ogdensburg, NY
  • NPI 1013759166
  NPD
• Carthage Area Hospital, Inc.

  • Obstetrics & Gynecology Physician
  • Carthage, NY
  • NPI 1528279817
  NPD

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

{
    "created_epoch": "1436745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620086400000",
    "number": "1174907828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 BRIDGE ST",
            "city": "CARTHAGE",
            "state": "NY",
            "postal_code": "136191360",
            "telephone_number": "315-493-3300",
            "fax_number": "315-493-3306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 BRIDGE ST",
            "city": "CARTHAGE",
            "state": "NY",
            "postal_code": "136191360",
            "telephone_number": "315-493-3300",
            "fax_number": "315-493-3306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOHANNON",
        "first_name": "THEA",
        "middle_name": "KAITLYNNE",
        "name_prefix": "Ms.",
        "credential": "MS, LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-13",
        "last_updated": "2021-05-04",
        "certification_date": "2021-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "008393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pauline Beck, LMSW
• Shawna Rae Berry, LMSW
• Maryellen Blevins, PA
• Kristen Bloom, MHC
• William Blunden, PT
• Brooke A. Boldt, M.S. CCC-SLP
• Jerian Ouano Boliver, RDH
• Janel Boni
• Daniel Vann Boshart, RPH
• Bossuot-Lundy Funeral Home (Lundy Services)

• Mental Health Counselor in Carthage, NY
• Providers in Carthage, NY by specialty
• Mental Health Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.