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THERESA DEWALT
NPI 1699933036
Counselor - Professional in Racine, WI

Active since May 31, 2008
1220 MOUND AVE STE 304, RACINE, WI 53404(262) 488-0011 Get Directions Write a Review

NPPES record last updated: May 31, 2008. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Theresa Dewalt NPPES

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

THERESA DEWALT (NPI 1699933036) is an individual professional provider in Racine, Wisconsin, licensed in Wisconsin (3369-125) and active in the NPI registry since May 2008.

NPPES Registry Identity

NPI1699933036
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameTHERESA DEWALT
Location Address1220 MOUND AVE STE 304Racine, WI 53404-3350
Mailing Address1220 Mound Ave Ste 304Racine, WI 53404-3350 · (262) 488-0011
Phone(262) 488-0011
Sole ProprietorYes
Enumeration DateMay 31, 2008
✔ NPI 1699933036 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in WI · 3369-125
1220 MOUND AVE STE 304, Racine, WI 53404
Open in Google Maps ↗

Other Identifiers 1

Medicaid40978600WI

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 Theresa Dewalt's NPI number?

The NPI number for Theresa Dewalt is 1699933036. It was assigned to this individual provider in the NPPES registry on May 31, 2008.

Where is Theresa Dewalt located?

Theresa Dewalt practices at 1220 Mound Ave Ste 304, Racine, WI 53404. The listed phone number is (262) 488-0011.

What is Theresa Dewalt's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

When was this NPI record last updated?

The NPPES record for Theresa Dewalt was last updated on May 31, 2008. NPI Profile syncs with the weekly NPPES data releases published by CMS.