Mina Rae Thevenin, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

1947 Issued in KY

Practice address

8521 Lagrange Rd
Louisville, KY 40242-3800

Phone

(502) 814-3721

Fax

(502) 814-3575

NPI assigned

Jul 23, 2006

Last updated

Jul 8, 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

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

Specialty

Clinical Social Worker

Education

Other, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1153612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1467473488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 221083",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "40241",
            "telephone_number": "502-814-3721",
            "fax_number": "502-814-3575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8521 LAGRANGE RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402423800",
            "telephone_number": "502-814-3721",
            "fax_number": "502-814-3575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEVENIN",
        "first_name": "MINA",
        "middle_name": "RAE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "1947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Therapy Room LLP
• Therapy Unlimited, Incorporated
• Therapy Works, Inc
• Theresa B Javier Inc
• Judith Ann Theriot, MD
• Jessica Thibault, PA-C
• Jacques Thibodeaux, MD
• Alan Thiele
• Elizabeth Thiele
• Erica Thielemann

• Clinical Social Worker in Louisville, KY
• Providers in Louisville, KY by specialty
• Clinical Social Worker in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.