Individual provider Active NPI

Wanda I Thies, LMFT

  • Marriage & Family Therapist
  • Fredericksburg, VA
National Provider Identifier
1912045261
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
0717001031 Issued in VA
Practice address
1125 Heatherstone Dr
101
Fredericksburg, VA 22407-4828
Phone
(540) 548-4114
Fax
(540) 548-2541
NPI assigned
Feb 1, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 0717001031 VA Primary

Addresses

Primary practice location

1125 Heatherstone Dr
101
Fredericksburg, VA 22407-4828

Mailing address

1125 Heatherstone Drive
101
Fredericksburg, VA 22407-4828
Phone (540) 548-4114

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

State licenses

LicenseStateTypeSpecialty
0717001031VAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Grace Counseling Center Marriage & Family Therapist Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1912045261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 HEATHERSTONE DRIVE",
            "address_2": "101",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224074828",
            "telephone_number": "540-548-4114",
            "fax_number": "540-548-2541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 HEATHERSTONE DR",
            "address_2": "101",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224074828",
            "telephone_number": "540-548-4114",
            "fax_number": "540-548-2541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIES",
        "first_name": "WANDA",
        "middle_name": "I",
        "name_prefix": "Mrs.",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "VA",
            "license": "0717001031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, VA

Sources for this page

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

Verify at the official NPI Registry.