THERESA MECHELLE THOMAS
NPI 1790315752
Counselor - Professional in Winder, GA
NPI Status: Active since January 17, 2020
Contact Information
46 S BROAD ST
WINDER, GA
ZIP 30680
Phone: (770) 246-2822
- Individual
- Female
- Counselor
- Professional
- Accepts Insurance
- Opted-Out Medicare
About THERESA THOMAS
This page provides the complete NPI Profile along with additional information for Theresa Thomas, a provider established in Winder, Georgia with a medical specialization in Counselor, focusing in professional . The healthcare provider is registered in the NPI registry with number 1790315752 assigned on January 2020. The practitioner's primary taxonomy code is 101YP2500X with license number LPC010110 (GA). The provider is registered as an individual and her NPI record was last updated one year ago.
- NPI
- 1790315752
- Provider Name
- THERESA MECHELLE THOMAS
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 46 S BROAD ST WINDER, GA 30680
- Location Phone
- (770) 246-2822
- Mailing Address
- 46 S BROAD ST WINDER, GA 30680
- Mailing Phone
- (770) 246-2822
- Is Sole Proprietor?
- No
- Enumeration Date
- 01-17-2020
- Last Update Date
- 12-01-2025
- Code Navigator
The provider doesn't accept Medicare and has signed an affidavit to be excluded from the Medicare program. If you are a Medicare beneficiary this means a provider can charge whatever they want for services rendered but must follow certain rules to do so. Theresa Thomas opted out of Medicare effective on 01-19-2024 until 01-19-2026. Opt out periods last for two years and cannot be terminated unless the provider is opting out for the very first time and the affidavit is terminated no later than 90 days after the opt out effective date. Opt-out affidavits might renew automatically renew every two years. The provider opted out of Medicare and cannot order and refer services to other healthcare providers.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Counselor Professional
- Taxonomy Code
- 101YP2500X
- Type
- Behavioral Health & Social Service Providers
- License No.
- LPC010110
- License State
- GA
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- SoloCare Bronze EPO $8500 DED HSA 10004 - EPO
- SoloCare Exp Bronze EPO $9500 DED 10015 - EPO
- SoloCare Gold EPO $1500 DED 10010 - EPO
- SoloCare Silver EPO $5000 DED 10014 - EPO
- SoloCare Silver EPO $6500 DED 10013 - EPO
- SoloCare Standard Exp Bronze EPO $7500 DED 10008 - EPO
- SoloCare Standard Gold EPO $2000 DED 10006 - EPO
- SoloCare Standard Platinum EPO $0 DED 10005 - EPO
- SoloCare Standard Silver EPO $6000 DED 10007 - EPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| LPC010110 | OTHER (01) | GA | STATE LICENSE |
Medicare Participation & PECOS Enrollment Status
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Opted-Out of Medicare? Yes
Opt-Out Effective Date: 01-19-2024
Opt-Out End Date: 01-19-2026
Eligible to Order and Refer? No
Reviews for THERESA MECHELLE THOMAS
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1790315752, we treat the final digit (2) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 58. The final step is to find the difference between that total and the next multiple of ten (60 - 58 = 2).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 58 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 2 providers are registered at the same or a nearby location.
WINDER, GA 30680
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1790315752, enumerated as an "individual" on January 17, 2020.
The provider is located at 46 S BROAD ST WINDER, GA 30680 and the phone number is (770) 246-2822.
Counselor with taxonomy code 101YP2500X and a focus in Professional.
The provider might be accepting Accepts: Alliant Health Plans, Inc., Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
