Active NPI
Thomas Richard McBride
- Addiction (Substance Use Disorder) Counselor
- Kelso, WA
National Provider Identifier
1003621772
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- CO61592915
- Practice address
- 305 Pacific Ave S Ste C
Kelso, WA 98626-1638 - Phone
- (360) 425-5378
- NPI assigned
- Feb 10, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CO61592915 | WA | Primary |
Addresses
Primary practice location
305 Pacific Ave S Ste C
Kelso, WA 98626-1638
Mailing address
305 Pacific Ave S Ste C
Kelso, WA 98626-1638
Phone (360) 425-5378
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CO61592915 | WA | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1739145600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1739145600000",
"number": "1003621772",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "305 PACIFIC AVE S STE C",
"city": "KELSO",
"state": "WA",
"postal_code": "986261638",
"telephone_number": "360-425-5378"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "305 PACIFIC AVE S STE C",
"city": "KELSO",
"state": "WA",
"postal_code": "986261638",
"telephone_number": "360-425-5378"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCBRIDE",
"first_name": "THOMAS",
"middle_name": "RICHARD",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-02-10",
"last_updated": "2025-02-10",
"certification_date": "2025-02-10",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "WA",
"license": "CO61592915",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kelso, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.