Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kristine Marie Thackrey, LISW, LICDC

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1497819916

Kristine Marie Thackrey, LISW, LICDC is a Clinical Social Worker in Lima, Ohio. Qualified in 1990, 36 years ago. Practices with Dakota Professional Corp, a 2-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Ohio.

Years since qualifying
36
Licensed in
OH
In the registry since
2006
Specialties on file
2
What do these letters mean?
LISW — Licensed Independent Social Worker
A social worker licensed to practise independently.

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Practice location Address checks out

3611 S Dixie Hwy
Lima, OH 45804-3750
Phone: (419) 999-2024
Fax: (419) 999-2024
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Addiction (Substance Use Disorder) Counselor (primary) Taxonomy 101YA0400X · Licence 933608 (OH)
Clinical Social Worker Taxonomy 1041C0700X · Licence I5522 (OH)

Record details

NPI number1497819916
Entity typeIndividual (Type 1)
GenderFemale
Credentials LISW , LICDC
Sole proprietorNo
NPI enumeratedDecember 20, 2006
Last updated in NPPESSeptember 11, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 1990 (36 years in practice)
Group practice Dakota Professional Corp — 2 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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