Individual provider Active NPI

Kristen Toni Thomas, LCSW

  • Clinical Social Worker
  • Fernandina Beach, FL
National Provider Identifier
1083570790
Registry record updated Dec 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW25651 Issued in FL
Practice address
1201 Atlantic Ave
Fernandina Beach, FL 32034-3403
Phone
(912) 552-2040
NPI assigned
Dec 27, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW25651 FL Primary

Addresses

Primary practice location

1201 Atlantic Ave
Fernandina Beach, FL 32034-3403

Mailing address

145 Woodbridge Rd
Kingsland, GA 31548-3373
Phone (912) 552-2040

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

LicenseStateTypeSpecialty
SW25651FLMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1766793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766793600000",
    "number": "1083570790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 WOODBRIDGE RD",
            "city": "KINGSLAND",
            "state": "GA",
            "postal_code": "315483373",
            "telephone_number": "912-552-2040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 ATLANTIC AVE",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320343403",
            "telephone_number": "912-552-2040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "KRISTEN",
        "middle_name": "TONI",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-12-27",
        "last_updated": "2025-12-27",
        "certification_date": "2025-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW25651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fernandina Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 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.

Verify at the official NPI Registry.