Mary K Theil, LPCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

E0002685 Issued in OH

Practice address

40722 State Route 154
Lisbon, OH 44432-8500

Phone

(330) 424-9573

Fax

(330) 424-0877

NPI assigned

Jan 15, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mary K Kimmett Professional name

Medicare fee-for-service enrollment

Enrolled in OH

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mary.theillpcc.p1@direct.sandy.nextgenshare.com

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.

• Community Action Agency of Columbiana County Inc

  • Federally Qualified Health Center (FQHC)
  • Lisbon, OH
  • NPI 1821041401
  Medicare reassignment NPD
• Community Action Agency of Columbiana County Inc

  • Federally Qualified Health Center (FQHC)
  • Hanoverton, OH
  • NPI 1225914112
  NPD
• Community Action Agency of Columbiana County, Inc

  • Federally Qualified Health Center (FQHC)
  • East Liverpool, OH
  • NPI 1841780863
  NPD
• Community Action Agency of Columbiana County Inc

  • Federally Qualified Health Center (FQHC)
  • Salineville, OH
  • NPI 1508114893
  NPD (past)
• Community Action Agency of Columbiana County, Inc

  • Federally Qualified Health Center (FQHC)
  • Salem, OH
  • NPI 1356064414
  NPD (past)

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

{
    "created_epoch": "1168819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649321043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219 QUINCY AVE",
            "city": "COLUMBIANA",
            "state": "OH",
            "postal_code": "444081435",
            "telephone_number": "330-424-9573",
            "fax_number": "330-424-0877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40722 STATE ROUTE 154",
            "city": "LISBON",
            "state": "OH",
            "postal_code": "444328500",
            "telephone_number": "330-424-9573",
            "fax_number": "330-424-0877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEIL",
        "first_name": "MARY",
        "middle_name": "K",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E0002685",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "KIMMETT",
            "middle_name": "K",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Jennifer Sullivan
• Gwen Swiger, QMHS
• Charlene Tabet
• Hollis Ann Tataseo, LPN
• Emily Jane Taylor, MS, RDN, LD
• Barbara Thornberry, AU.D.
• Brenda Thurnher, M.ED., ED.S. CERT.
• Mary Teresa Todd, M.S.ED QMHS
• Edward Sears Toolis, DDS
• Heather Torhan, COTA/L

• Professional Counselor in Lisbon, OH
• Providers in Lisbon, OH by specialty
• Professional Counselor in Ohio

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.