Thad Matthew Shunkwiler, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

2259 Issued in MN

Practice address

1400 Madison Ave; Suite 610
Adult, Child & Family Services, LLC
Mankato, MN 56001

Phone

(507) 387-3777

Fax

(507) 344-1726

NPI assigned

Apr 29, 2014

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

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.

• Adult, Child & Family Services, LLC

  • Psychologist
  • Mankato, MN
  • NPI 1902806045
  NPD

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

{
    "created_epoch": "1398729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1912317090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 MADISON AVE; SUITE 610",
            "address_2": "ADULT, CHILD & FAMILY SERVICES LLC",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "56001",
            "telephone_number": "507-387-3777",
            "fax_number": "507-344-1726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 MADISON AVE; SUITE 610",
            "address_2": "ADULT, CHILD & FAMILY SERVICES, LLC",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "56001",
            "telephone_number": "507-387-3777",
            "fax_number": "507-344-1726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUNKWILER",
        "first_name": "THAD",
        "middle_name": "MATTHEW",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-29",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "CC00517",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "2259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Marriage & Family Therapist in Mankato, MN
• Providers in Mankato, MN by specialty
• Marriage & Family Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.