Thea Vondracek, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

1326 Issued in NC

Practice address

1931 New Garden Rd Ste 212
Greensboro, NC 27410-2556

Phone

(336) 338-2011

NPI assigned

Jun 13, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1181692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655078400000",
    "number": "1700080801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 KOTCHS GROVE CT",
            "city": "BROWNS SUMMIT",
            "state": "NC",
            "postal_code": "272149437",
            "telephone_number": "336-295-3191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1931 NEW GARDEN RD STE 212",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274102556",
            "telephone_number": "336-338-2011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VONDRACEK",
        "first_name": "THEA",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-13",
        "last_updated": "2022-06-13",
        "certification_date": "2022-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NC",
            "license": "1326",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6103607",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Marriage & Family Therapist in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Marriage & Family Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 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.