Individual provider Active NPI

John Monstre Thigpen, MSW, SUDP, LICSW

  • Clinical Social Worker
  • Silverdale, WA
National Provider Identifier
1093250698
Registry record updated Feb 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LW60901801 Issued in WA
Practice address
3888 NW Randall Way Ste 201
Silverdale, WA 98383-7847
Phone
(360) 698-5883
Fax
(360) 809-6002
NPI assigned
Jan 5, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X CP60494074 WA
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X LW60901801 WA Primary

Addresses

Primary practice location

3888 NW Randall Way Ste 201
Silverdale, WA 98383-7847

Mailing address

9633 Levin Rd NW
Silverdale, WA 98383-8131
Phone (360) 698-5883

Other identifiers 1

IdentifierTypeStateIssuer
2153701MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Mar 22, 2025 through Mar 22, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CP60494074WAMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Mental Health Center of Tacoma-Pierce County Multi-Specialty PastSince Oct 10, 2017 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1483574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739232000000",
    "number": "1093250698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9633 LEVIN RD NW",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983838131",
            "telephone_number": "360-698-5883",
            "fax_number": "360-782-9586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3888 NW RANDALL WAY STE 201",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983837847",
            "telephone_number": "360-698-5883",
            "fax_number": "360-809-6002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIGPEN",
        "first_name": "JOHN",
        "middle_name": "MONSTRE",
        "credential": "MSW, SUDP, LICSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-01-05",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CP60494074",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW60901801",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2153701",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Silverdale, WA

Sources for this page

Verify at the official NPI Registry.