Individual provider Active NPI

Kathleen Thurmond, LCSW

  • Clinical Social Worker
  • Long Beach, CA
National Provider Identifier
1194394841
Registry record updated Jun 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW12514 Issued in CA
Practice address
5479 E Abbeyfield St Ste 3
Long Beach, CA 90815-3050
Phone
(562) 879-1602
NPI assigned
Jun 17, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2021

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 LCSW12514 CA Primary

Addresses

Primary practice location

5479 E Abbeyfield St Ste 3
Long Beach, CA 90815-3050

Mailing address

288 Temple Ave
Long Beach, CA 90803-5435
Phone (562) 879-1602

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
LCSW12514CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Abbeyfield Psychotherapy Inc Clinical Past 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": "1623888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623888000000",
    "number": "1194394841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "288 TEMPLE AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908035435",
            "telephone_number": "562-879-1602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5479 E ABBEYFIELD ST STE 3",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908153050",
            "telephone_number": "562-879-1602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THURMOND",
        "first_name": "KATHLEEN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-17",
        "last_updated": "2021-06-17",
        "certification_date": "2021-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW12514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2021; 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.