Deborah Ann Thibeault, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6290 Issued in TN

Practice address

325 N State of Franklin Rd
Johnson City, TN 37604-6056

Phone

(423) 439-7320

Fax

(423) 439-7343

NPI assigned

Sep 26, 2010

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1285459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446422400000",
    "number": "1013226018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 699",
            "city": "MOUNTAIN HOME",
            "state": "TN",
            "postal_code": "376840699",
            "telephone_number": "423-433-6039",
            "fax_number": "423-433-6060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 N STATE OF FRANKLIN RD",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376046056",
            "telephone_number": "423-439-7320",
            "fax_number": "423-439-7343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIBEAULT",
        "first_name": "DEBORAH",
        "middle_name": "ANN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-26",
        "last_updated": "2015-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "6290",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE",
            "identifier": "3714470",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6007677",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• The Michal Child Development Center
• The Reeves Eye Institute
• The Regional Center for Oral & Maxillofacial Surgery, PC
• The Waters of Johnson City LLC
• Pitchar Theerathorn, MD
• James Owen Thigpen, PA-C
• Bethany B Thomas, SPEECH PATHOLOGIST
• Brandi Lynn Thomas, FNP
• Candace Thomas, DO
• Cynde L Thomas, CRNA

• Clinical Social Worker in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Clinical Social Worker in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.