Patrice Thibodeau, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2015035786 Issued in MO

Practice address

400 N Washington St
Suite 116
Farmington, MO 63640-1716

Phone

(573) 218-9653

Fax

(573) 803-1405

NPI assigned

Feb 6, 2016

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Tender Hearts Child Therapy Center, LLC

  • Professional Counselor
  • Cape Girardeau, MO
  • NPI 1568777910
  NPD (past)

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

{
    "created_epoch": "1454716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454716800000",
    "number": "1255799185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2909 INDEPENDENCE ST",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637035044",
            "telephone_number": "573-803-1402",
            "fax_number": "573-803-1405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N WASHINGTON ST",
            "address_2": "SUITE 116",
            "city": "FARMINGTON",
            "state": "MO",
            "postal_code": "636401716",
            "telephone_number": "573-218-9653",
            "fax_number": "573-803-1405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIBODEAU",
        "first_name": "PATRICE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-06",
        "last_updated": "2016-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2015035786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David M Tesreau
• The Heart Health Center, PC
• The Little Learners Spectrum Center Inc.
• Thebeau Inc
• Clint Thebeau
• Gary L Thomas, RPH
• Madisen Thomas
• Tiffany Ann Thomas
• Cindi Gay Thurman, OTR/L
• Timothy M. O'Bryan DDS, LLC

• Clinical Social Worker in Farmington, MO
• Providers in Farmington, MO by specialty
• Clinical Social Worker in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2016; 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.