Individual provider Active NPI

Kenneth N Thomas, MHS LCADC CAC DP LPC

  • Addiction (Substance Use Disorder) Counselor
  • East Stroudsburg, PA
National Provider Identifier
1124318811
Registry record updated Jul 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
37LC00130200 Issued in NJ
Practice address
3064 Penn Estates
East Stroudsburg, PA 18301-8696
Phone
(201) 951-5596
NPI assigned
Apr 14, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X PC005579 PA
Professional Counselor 101YP2500X PC005579 PA
Addiction (Substance Use Disorder) Counselor 101YA0400X 37LC00130200 NJ Primary

Addresses

Primary practice location

3064 Penn Estates
East Stroudsburg, PA 18301-8696

Mailing address

930 N 9TH St
Stroudsburg, PA 18360-1208
Phone (201) 951-5596

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
37LC00130200NJMDAddiction (Substance Use Disorder) Counselor
PC005579PAMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1302739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564012800000",
    "number": "1124318811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "930 N 9TH ST",
            "city": "STROUDSBURG",
            "state": "PA",
            "postal_code": "183601208",
            "telephone_number": "201-951-5596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3064 PENN ESTATES",
            "city": "EAST STROUDSBURG",
            "state": "PA",
            "postal_code": "183018696",
            "telephone_number": "201-951-5596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "KENNETH",
        "middle_name": "N",
        "name_prefix": "Mr.",
        "credential": "MHS LCADC CAC DP LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-04-14",
        "last_updated": "2019-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "PA",
            "license": "PC005579",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC005579",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NJ",
            "license": "37LC00130200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Stroudsburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2019; 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.