Michelina H Therrien, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C005474 Issued in NC

Practice address

893 Pine Valley Rd
Jacksonville, NC 28546-7921

Phone

(386) 972-0677

Fax

(910) 353-7365

NPI assigned

Feb 17, 2007

Last updated

Aug 15, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1171670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187136000000",
    "number": "1275677791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "893 PINE VALLEY RD",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285467921",
            "telephone_number": "386-972-0677",
            "fax_number": "910-353-7365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "893 PINE VALLEY RD",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285467921",
            "telephone_number": "386-972-0677",
            "fax_number": "910-353-7365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THERRIEN",
        "first_name": "MICHELINA",
        "middle_name": "H",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-17",
        "last_updated": "2007-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW6423",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C005474",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• The Awakening Wellness Clinic, Inc
• The May Center for Autism Spectrum Disorders
• The Red Phoenix & Co.
• The Womens Clinic
• Therapy Flow
• Autumn Ann Thibault, LMFT
• Erin Smith Thoma, D.O.
• Amaya Thomann
• Thomas E & Kimberly M Morgan DDS PA
• Thomas J Rojy Jr MD PA

• Clinical Social Worker in Jacksonville, NC
• Providers in Jacksonville, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2007; 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.