Individual provider Active NPI

Marcia Thorsen, LCPC

  • Mental Health Counselor
  • Oblong, IL
National Provider Identifier
1538870480
Registry record updated Dec 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
180.014823 Issued in IL
Practice address
108 S Garfield St
Oblong, IL 62449-1464
Phone
(618) 769-2185
NPI assigned
Dec 12, 2022
Last updated
Dec 12, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2022

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 180.014823 IL Primary

Addresses

Primary practice location

108 S Garfield St
Oblong, IL 62449-1464

Mailing address

8767 N 1100TH St
Robinson, IL 62454-5916
Phone (912) 423-0453

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

State licenses

LicenseStateTypeSpecialty
180.014823ILMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1670803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670803200000",
    "number": "1538870480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8767 N 1100TH ST",
            "city": "ROBINSON",
            "state": "IL",
            "postal_code": "624545916",
            "telephone_number": "912-423-0453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 S GARFIELD ST",
            "city": "OBLONG",
            "state": "IL",
            "postal_code": "624491464",
            "telephone_number": "618-769-2185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THORSEN",
        "first_name": "MARCIA",
        "name_prefix": "Mrs.",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-12-12",
        "last_updated": "2022-12-12",
        "certification_date": "2022-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "180.014823",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oblong, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2022; 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.