Active NPI
Therisa J Kreilein, LCSW ACSW
- Clinical Psychologist
- Salem, IN
National Provider Identifier
1942279427
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 34000140A
- Practice address
- 305 East Walnut St.
Salem, IN 47167-8659 - Phone
- (812) 883-5274
- Fax
- (812) 883-5274
- NPI assigned
- Mar 16, 2006
- Last updated
- Nov 17, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 34000140A | IN | Primary |
| Clinical Social Worker | 1041C0700X | 34000140A | IN | |
| Clinical Social Worker | 1041C0700X | 412 | KY | |
| Marriage & Family Therapist | 106H00000X | 0343 | KY |
Addresses
Primary practice location
305 East Walnut St.
Salem, IN 47167-8659
Mailing address
5003 N Rinkers Creek Rd
Salem, IN 47167-8659
Phone (812) 883-5274
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34000140A | IN | MD | Clinical Social Worker |
| 412 | KY | MD | Clinical Social Worker |
| 0343 | KY | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142467200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1479340800000",
"number": "1942279427",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5003 N RINKERS CREEK RD",
"city": "SALEM",
"state": "IN",
"postal_code": "471678659",
"telephone_number": "812-883-5274",
"fax_number": "812-883-5274"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "305 EAST WALNUT ST.",
"city": "SALEM",
"state": "IN",
"postal_code": "471678659",
"telephone_number": "812-883-5274",
"fax_number": "812-883-5274"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KREILEIN",
"first_name": "THERISA",
"middle_name": "J",
"name_prefix": "Ms.",
"credential": "LCSW ACSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-03-16",
"last_updated": "2016-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "IN",
"license": "34000140A",
"primary": true
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IN",
"license": "34000140A",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "KY",
"license": "412",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "KY",
"license": "0343",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salem, IN
- John E Hategan, M.D. P C
- Elizabeth Ann Johnson, LSW
- Melissa Johnston, APRN
- Sarah Elizabeth Jones, NP
- Stephen E. Kemker, M.D.
- Kroger Limited Partnership I (Jay C Pharmacy #086)
- L Chirumamilla MD PC
- Christopher Lee, RN
- Lifespring Inc (Salem Community Medical Services)
- Lifespring Inc. (Salem Community Schools Health Center)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.