Kirstie Thibodeaux, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

65616 Issued in TX

Practice address

4810 Creekmoor Dr
San Antonio, TX 78220-4840

Phone

(409) 679-3309

Fax

(409) 679-3309

NPI assigned

May 27, 2025

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2016

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Active Behavioral Group, LLC

  • Clinical Social Worker
  • San Antonio, TX
  • NPI 1174232797
  Medicare reassignment NPD
• Active Behavioral Goals LLC

  • Clinical Social Worker
  • San Antonio, TX
  • NPI 1790416790
  NPD

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

{
    "created_epoch": "1748304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748304000000",
    "number": "1235922691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4810 CREEKMOOR DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782204840",
            "telephone_number": "409-679-3309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4810 CREEKMOOR DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782204840",
            "telephone_number": "409-679-3309",
            "fax_number": "409-679-3309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIBODEAUX",
        "first_name": "KIRSTIE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-05-27",
        "last_updated": "2025-05-27",
        "certification_date": "2025-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "65616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thi of Texas at San Antonio I, LLC
• Thi of Texas at San Antonio II, LLC
• Thi of Texas at San Antonio III, LLC
• O Thi
• Roshini Thiagarajan, MD
• Tamara M. Thibodeaux, FNP-BC
• Karla Renee Thiebaud, PH.D, P.T.
• Megan Lynn Thiedeman, M.S.S.
• Radonna Marie Thies-Jernigan, CTRS, TRS/TXC
• Marita Silvia Thies, APRN FNP-C

• Clinical Social Worker in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.