Gwendaline Danielle Thoreaux, M.A., L.P.C., C.A.C.

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

3210 Issued in CO

Practice address

1333 Iris Ave
Boulder, CO 80304-2226

Phone

(303) 443-0850

NPI assigned

Feb 1, 2012

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

Enrolled in CO

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

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1328054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425859200000",
    "number": "1912279233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1333 IRIS AVE",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803042226",
            "telephone_number": "303-443-8500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1333 IRIS AVE",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803042226",
            "telephone_number": "303-443-0850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOREAUX",
        "first_name": "GWENDALINE",
        "middle_name": "DANIELLE",
        "credential": "M.A., L.P.C., C.A.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-02-01",
        "last_updated": "2015-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CO",
            "license": "5880",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "3210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicholas Donald Thompson, LCSW
• Rebecca Thompson
• Reuben Bryn Thompson, FCAMT, BSCPT
• Roy W Thompson, M.D.
• Victor James Thompson, M.D.
• Catherine Thornber, LPCC
• Steven Michael Thornhill, PHARMD
• Jeffrey J Thramann, MD
• Three Peaks Medical LLC
• Thrive Counseling LLC

• Professional Counselor in Boulder, CO
• Providers in Boulder, CO by specialty
• Professional Counselor in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2015; 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.