1. Home
  2. Directory
  3. New York
  4. Carthage
  5. Counselor
  6. NPI Profile

MS. THEA KAITLYNNE BOHANNON MS, LMHC
NPI 1174907828
Counselor - Mental Health in Carthage, NY

Active since July 13, 2015PECOS Enrolled
3 BRIDGE ST, CARTHAGE, NY 13619(315) 493-3300(315) 493-3306 Get Directions Write a Review

NPPES record last updated: May 4, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Ms. Thea Kaitlynne Bohannon Ms, Lmhc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MS. THEA KAITLYNNE BOHANNON MS, LMHC (NPI 1174907828) is an individual mental health provider in Carthage, New York, licensed in New York (008393) and active in the NPI registry since July 2015. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1174907828
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameMS. THEA KAITLYNNE BOHANNONCredential: MS, LMHC
Location Address3 BRIDGE STCarthage, NY 13619-1360
Mailing Address3 Bridge StCarthage, NY 13619-1360 · (315) 493-3300 · Fax (315) 493-3306
Phone(315) 493-3300
Fax(315) 493-3306
Sole ProprietorNo
Enumeration DateJuly 13, 2015
Last NPPES UpdateMay 4, 2021
NPPES CertifiedMay 4, 2021
✔ NPI 1174907828 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in NY · 008393
3 BRIDGE ST, Carthage, NY 13619
Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ms. Thea Kaitlynne Bohannon Ms, Lmhc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Thea Bohannon reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Carthage Area Hospital Inc.
Same address
Urology
3 BRIDGE ST
Carthage, NY 13619
  • Reassigned Medicare billing, New York enrollment
  • 199 clinicians in this Medicare group
NPI 1720269863 (315) 493-4874

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. NATASHA WILLIS P.T.
Physical Therapy Assistant
3 BRIDGE ST
CARTHAGE, NY 13619
Jefferson County (315) 493-1340
MCCUE DENTAL CARTHAGE PC
Dentist (General Practice)
3 BRIDGE ST
CARTHAGE, NY 13619
Jefferson County (315) 493-3510
BRENDA ROUSSEL
Behavior Analyst
3 BRIDGE ST, PHYSICAL THERAPY SUITE
CARTHAGE, NY 13619
Jefferson County (315) 493-1395
CARTHAGE AREA HOSPITAL INC
Clinic/Center (Dental)
3 BRIDGE ST
CARTHAGE, NY 13619
Jefferson County (315) 493-3510
CARLA HAAS LMSW
Social Worker
3 BRIDGE ST
CARTHAGE, NY 13619
Jefferson County (315) 493-3300
VALLEEN HORSEY LMSW
Social Worker
3 BRIDGE ST
CARTHAGE, NY 13619
Jefferson County (315) 493-3300
TRACY M. TOUSANT LCSW
Social Worker (Clinical)
3 BRIDGE ST
CARTHAGE, NY 13619
Jefferson County (315) 493-3300
MR. WOJCIECH JAN KONOPKA LMSW
Social Worker (Clinical)
3 BRIDGE ST
CARTHAGE, NY 13619
Jefferson County (315) 493-4180

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Thea Bohannon's NPI number?

The NPI number for Thea Bohannon is 1174907828. It was assigned to this individual provider in the NPPES registry on July 13, 2015.

Where is Thea Bohannon located?

Thea Bohannon practices at 3 Bridge St, Carthage, NY 13619. The listed phone number is (315) 493-3300.

What is Thea Bohannon's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Thea Bohannon enrolled in Medicare?

Yes. Thea Bohannon is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Thea Bohannon's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Thea Bohannon reassigns Medicare benefits to Carthage Area Hospital Inc. (Carthage, NY). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Thea Bohannon's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Thea Bohannon was last updated on May 4, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.