Provider Demographics
NPI:1003106295
Name:THIEDA, KATE (MS, LPC, NCC)
Entity Type:Individual
Prefix:
First Name:KATE
Middle Name:
Last Name:THIEDA
Suffix:
Gender:F
Credentials:MS, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 W MAIN ST
Mailing Address - Street 2:SUITE 400A
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-4640
Mailing Address - Country:US
Mailing Address - Phone:919-416-1727
Mailing Address - Fax:
Practice Address - Street 1:2200 W MAIN ST
Practice Address - Street 2:SUITE 400A
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-4640
Practice Address - Country:US
Practice Address - Phone:919-416-1727
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-09
Last Update Date:2015-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional