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Individual
KRISTINE MARIE THACKREY
Active
Individual
KRISTINE MARIE THACKREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISW, LICDC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
933608
OH
1041C0700X
Clinical Social Worker
I5522
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000352379
ANTHEM BLUE CROSS AND BLU
OH
Enumeration date
12/20/2006
Last updated
09/11/2025
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