MEDICARE: MS. ANNMARIE THIESSEN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	P129447	NY

General Provider Information

NPI Number	:	1437000130
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ANNMARIE THIESSEN

Provider Business Mailing Address
First Line	:	3 FORESTER AVE # 25
Second Line	:
City	:	WARWICK
State	:	NY
Zip	:	10990-1129
Country	:	US
Telephone Number	:	845-475-8422
Fax Number	:

Provider Business Practice Location Address
First Line	:	3 FORESTER AVE # 25
Second Line	:
City	:	WARWICK
State	:	NY
Zip	:	10990-1129
Country	:	US
Telephone Number	:	845-475-8422
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/07/2026
Last Update Date	:	02/07/2026

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