Kristin Jeanne Thomson, MS, CSAC, LPC-IT

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

16235 Issued in WI

Practice address

11390 W Theodore Trecker Way
West Allis, WI 53214-1135

Phone

(414) 928-1401

Fax

(414) 928-1402

NPI assigned

Dec 18, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Kristin Wilson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1513555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633392000000",
    "number": "1356857023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11390 W THEODORE TRECKER WAY",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532141135",
            "telephone_number": "414-928-1401",
            "fax_number": "414-928-1402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11390 W THEODORE TRECKER WAY",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532141135",
            "telephone_number": "414-928-1401",
            "fax_number": "414-928-1402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMSON",
        "first_name": "KRISTIN",
        "middle_name": "JEANNE",
        "credential": "MS, CSAC, LPC-IT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-18",
        "last_updated": "2021-10-05",
        "certification_date": "2021-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "16235",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "4079",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTIN",
            "last_name": "WILSON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Third Wave Psychotherapy & Assessment, LLC
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• Elizabeth C Thompson, MD
• Timothy J Thompson, MD
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• Mara Tibbals
• Tiger Lily Collective LLC
• Dean-Yar Tigrani, M.D.
• Molly A Tilleson, M.S.,CCC-SLP

• Addiction (Substance Use Disorder) Counselor in West Allis, WI
• Providers in West Allis, WI by specialty
• Addiction (Substance Use Disorder) Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 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.

Verify at the official NPI Registry.