Carissa Mae Thelen, OTRL

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

5201013761 Issued in MI

Practice address

701 W Front St
Traverse City, MI 49684-2287

Phone

(231) 935-0800

NPI assigned

May 11, 2021

Last updated

Aug 29, 2024By the provider in NPPES

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

• Carissa Mae Kuchenberg Former name

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hand Surgery of Northern Michigan PLCGroup PAC ID 4183639859, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Hand Surgery of Northern Michigan PLC

  dba Traverse Bay Hand Therapy PLC

  • Orthopaedic Hand Surgery Physician
  • Traverse City, MI
  • NPI 1497778765
  Medicare reassignment Care Compare group NPD
• Hand Surgery of Northern Michigan PLC

  dba Traverse Bay Hand Therapy PLC

  • Durable Medical Equipment & Medical Supplies
  • Traverse City, MI
  • NPI 1356487870

  Occupational Therapist

  NPD
• Lighthouse, Inc.

  • Rehabilitation Clinic/Center
  • Caro, MI
  • NPI 1770661092
  NPD (past)

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

{
    "created_epoch": "1620691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724889600000",
    "number": "1689258139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10670 E PICO DR",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496845382",
            "telephone_number": "906-241-3521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 W FRONT ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842287",
            "telephone_number": "231-935-0800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THELEN",
        "first_name": "CARISSA",
        "middle_name": "MAE",
        "credential": "OTRL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-11",
        "last_updated": "2024-08-29",
        "certification_date": "2024-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201013761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARISSA",
            "last_name": "KUCHENBERG",
            "middle_name": "MAE",
            "credential": "OTRL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• The Resiliency Therapy Center, PLLC (The Resiliency Therapy Center)
• The Skin Cancer and Dermatology Center PLC
• The Studio Art Therapy & Counseling
• The Surgery Center
• The Surgery Center
• Therapy North LLC
• Theresa a Evans LMSW PLLC
• Theresa Evans LMSW Caadc LLC (Trillium Counseling Services)
• Amber Therrien
• Adrianna Margaux Thibault, MD

• Occupational Therapist in Traverse City, MI
• Providers in Traverse City, MI by specialty
• Occupational Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.