Theresa Waddell, MA, MS, CADC, MFTA

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

118429 Issued in KY

Practice address

400 Ring Rd Ste 155
Elizabethtown, KY 42701-8790

Phone

(844) 473-6378

NPI assigned

Oct 15, 2015

Last updated

Jun 11, 2026By 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 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts, Master of Science

State licenses

Practice roles

Locations

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

• Renest (I) Rise

  • Community/Behavioral Health Agency
  • Elizabethtown, KY
  • NPI 1811861255
  NPD Authorized official
• Renest Recovery Support Services

  dba reNEST

  • Community/Behavioral Health Agency
  • Elizabethtown, KY
  • NPI 1437624814
  NPD Authorized official
• Renest Recovery Support Services

  dba reNEST Transpo Dept

  • Taxi
  • Elizabethtown, KY
  • NPI 1740907096
  NPD Authorized official
• Renest Residence Inc

  • Community/Behavioral Health Agency
  • Elizabethtown, KY
  • NPI 1992634174
  Authorized official Same address or phone
• Renest of Illinois Supr

  dba reNEST

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Rockford, IL
  • NPI 1871228494
  Authorized official Same address or phone
• Renest Recovery Support Services of Illinois

  dba reNEST Recovery Support Service Rockford LLC

  • Adult Mental Health Clinic/Center
  • Rockford, IL
  • NPI 1093307266
  NPD
• The Commitment House LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Clarksville, IN
  • NPI 1801296314
  NPD (past)

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

{
    "created_epoch": "1444867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781136000000",
    "number": "1669843710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 RING RD STE 155",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427018790",
            "telephone_number": "844-473-6378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 RING RD STE 155",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427018790",
            "telephone_number": "844-473-6378"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "910 2nd Ave",
            "address_purpose": "LOCATION",
            "city": "Rockford",
            "state": "IL",
            "postal_code": "611042162",
            "country_code": "US",
            "telephone_number": "844-473-6378",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WADDELL",
        "first_name": "THERESA",
        "credential": "MA, MS, CADC, MFTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-15",
        "last_updated": "2026-06-11",
        "certification_date": "2026-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "KY",
            "license": "118429",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "KY",
            "license": "298308",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Louann Vonallmen
• Harrison Vong, D.M.D.
• Kayla Vornberger
• W I N G S Community Support & Recovery Services
• Lakishia Waddell, TCSW
• Cornelia Wade, NP
• Hailey Wagner, OTR
• Wal-Mart Stores East LP (Walmart Pharmacy 10-0709)
• Wal-Mart Stores East, LP (Vision Center 30-0709)
• Lucia Francheskia Walbert, APSS

• Addiction (Substance Use Disorder) Counselor in Elizabethtown, KY
• Providers in Elizabethtown, KY by specialty
• Addiction (Substance Use Disorder) Counselor in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2026; 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.