Individual provider Active NPI

Kaitlin Therien, M.S

  • Mental Health Counselor
  • Fuquay Varina, NC
National Provider Identifier
1497311658
Registry record updated Apr 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
1633 Kauri Cliffs Dr
Fuquay Varina, NC 27526-3834
Phone
(401) 595-6332
NPI assigned
May 14, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

1633 Kauri Cliffs Dr
Fuquay Varina, NC 27526-3834

Mailing address

1633 Kauri Cliffs Dr
Fuquay Varina, NC 27526-3834

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
South Bay Mental Health Center, Inc. PastSince May 1, 2020 Accepting new patients
SB Transitional Sub, LLC PastSince May 17, 2021 Accepting new patients
Southern Wake Counseling Center Mental Health Past Accepting new patients

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1557792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682294400000",
    "number": "1497311658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1633 KAURI CLIFFS DR",
            "city": "FUQUAY VARINA",
            "state": "NC",
            "postal_code": "275263834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1633 KAURI CLIFFS DR",
            "city": "FUQUAY VARINA",
            "state": "NC",
            "postal_code": "275263834",
            "telephone_number": "401-595-6332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THERIEN",
        "first_name": "KAITLIN",
        "credential": "M.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-14",
        "last_updated": "2023-04-24",
        "certification_date": "2023-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fuquay Varina, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2023; 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.