Kim Marie Thurston, DR

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PS019851 Issued in PA

Practice address

1003 Pennsylvania Ave W
Warren, PA 16365-1876

Phone

(814) 817-1400

Fax

(814) 817-1447

NPI assigned

Aug 14, 2023

Last updated

Aug 14, 2023By the provider in NPPES

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

Enrolled in PA

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 Psychologist

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Deerfield Behavioral Health of Warren, LLCGroup PAC ID 8325935661, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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

• Deerfield Behavioral Health of Warren, LLC

  • Psychiatry Physician
  • Warren, PA
  • NPI 1134158314
  Medicare reassignment Care Compare group NPD
• Children's Center for Treatment and Education

  dba Beacon Light Behavioral Health System

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Warren, PA
  • NPI 1366609646
  Medicare reassignment NPD
• Childrens Center for Treatment and Education

  dba Beacon Light Behavioral Health Systems

  • Clinical Psychologist
  • Bradford, PA
  • NPI 1477626992
  NPD

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

{
    "created_epoch": "1691971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691971200000",
    "number": "1316720584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 E MAIN ST",
            "city": "BRADFORD",
            "state": "PA",
            "postal_code": "167013278",
            "telephone_number": "814-817-1400",
            "fax_number": "814-817-1447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 PENNSYLVANIA AVE W",
            "city": "WARREN",
            "state": "PA",
            "postal_code": "163651876",
            "telephone_number": "814-817-1400",
            "fax_number": "814-817-1447"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1885 Market St",
            "address_purpose": "LOCATION",
            "city": "Warren",
            "state": "PA",
            "postal_code": "163651277",
            "country_code": "US",
            "telephone_number": "814-723-1832",
            "fax_number": "814-817-1447",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THURSTON",
        "first_name": "KIM",
        "middle_name": "MARIE",
        "credential": "DR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-14",
        "last_updated": "2023-08-14",
        "certification_date": "2023-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PA",
            "license": "PS019851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jada K Swart
• Taylor N. Day, PHD PLLC (Dr. Tay Concierge Clinical Care)
• Renee Nicole Taylor
• Nicole Marie Theuret, PMHNP-BC
• Jennifer Thrift, NP
• Celeste Tidrick, LPC
• Timothy S Stanton MD
• Daniel Alan Toombs, D.C.
• Mason Tootell, M.D.
• Christine Topa, CCCSLP

• Psychologist in Warren, PA
• Providers in Warren, PA by specialty
• Psychologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2023; 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.