John Thacker

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

9455 Issued in NC

Practice address

741 Highland Ave
Winston Salem, NC 27101-4206

Phone

(336) 703-3751

NPI assigned

Nov 17, 2012

Last updated

Mar 9, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1353110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457481600000",
    "number": "1457695298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "741 HIGHLAND AVE",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271014206",
            "telephone_number": "335-575-5948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "741 HIGHLAND AVE",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271014206",
            "telephone_number": "336-703-3751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THACKER",
        "first_name": "JOHN",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-11-17",
        "last_updated": "2016-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NC",
            "license": "9455",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "20293",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "9455",
            "primary": true
        },
        {
            "code": "225C00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Counselor",
            "state": "NC",
            "license": "00115237",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paige Koonts Tesh, NNP-BC
• Jade Anthony Teta, N.D.
• John Klein Teta, ND, LAC, CSCS
• Neil B Thackar, DO
• Angela Nicole Thacker
• Michelle Rene Thames, FNP
• Ue Thao, PA C
• Rupak Thapa, MD
• Melissa York Tharpe, WHNP
• Luqman Arafath Thazhathuveetil Kunhahamed, M.D.

• Mental Health Counselor in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2016; 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.