Active NPI
Kristen Button Thibodeau, PSYD
- Clinical Psychologist
- Derry, NH
National Provider Identifier
1336734193
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 758
- Practice address
- 28 S Main St
Derry, NH 03038-2142 - Phone
- (603) 432-1233
- NPI assigned
- Mar 3, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 758 | NH | Primary |
Addresses
Primary practice location
28 S Main St
Derry, NH 03038-2142
Mailing address
99 Hickory Rd
Hampstead, NH 03841-2226
Phone (603) 560-5199
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
| License | State | Type | Specialty |
|---|---|---|---|
| 758 | NH | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1614729600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1614729600000",
"number": "1336734193",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "99 HICKORY RD",
"city": "HAMPSTEAD",
"state": "NH",
"postal_code": "038412226",
"telephone_number": "603-560-5199"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "28 S MAIN ST",
"city": "DERRY",
"state": "NH",
"postal_code": "030382142",
"telephone_number": "603-432-1233"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THIBODEAU",
"first_name": "KRISTEN",
"middle_name": "BUTTON",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-03-03",
"last_updated": "2021-03-03",
"certification_date": "2021-03-03",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NH",
"license": "758",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Derry, NH
- Tender Care Incorporated
- The Granite House Sober Living, LLC
- The Mental Health Ctr for Southern New Hampshire
- The Upper Room, a Family Resource Center
- Thi of New Hampshire at Derry, LLC
- Anne Meredith Thomassen, APRN,NP-C
- Thrivewell Mental Telehealth, PLLC
- Ti - Derry LLC
- Time for Me Counseling PLLC
- TJD Counseling, Inc.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 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.