Active NPI
Thakena Deriess Hogue, MA, LMHC, LMFT
- Mental Health Counselor
- Indianapolis, IN
National Provider Identifier
1619145000
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 39001904A
- Practice address
- 1812 N Capitol Ave
Suite 440
Indianapolis, IN 46202-1218 - Phone
- (317) 962-2486
- NPI assigned
- Feb 19, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 39001904A | IN | Primary |
| Marriage & Family Therapist | 106H00000X | 35001646A | IN | |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 87000284A | IN |
Addresses
Primary practice location
1812 N Capitol Ave
Suite 440
Indianapolis, IN 46202-1218
Mailing address
1812 N Capitol Ave
Suite 440
Indianapolis, IN 46202-1218
Phone (317) 962-2486
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000538795 | Other | IN | ANTHEM |
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 Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 87000284A | IN | MD | Addiction (Substance Use Disorder) Counselor |
| 39001904A | IN | MD | Mental Health Counselor |
| 35001646A | IN | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1203379200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1292889600000",
"number": "1619145000",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1812 N CAPITOL AVE",
"address_2": "SUITE 440",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462021218",
"telephone_number": "317-962-2486"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1812 N CAPITOL AVE",
"address_2": "SUITE 440",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462021218",
"telephone_number": "317-962-2486"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOGUE",
"first_name": "THAKENA",
"middle_name": "DERIESS",
"credential": "MA, LMHC, LMFT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-02-19",
"last_updated": "2010-12-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IN",
"license": "39001904A",
"primary": true
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "IN",
"license": "35001646A",
"primary": false
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "IN",
"license": "87000284A",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "000000538795",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.