Individual provider Active NPI

Thurmond Kirkland, LPC, LMSW, QMRP

  • Mental Health Counselor
  • Port Huron, MI
National Provider Identifier
1376652941
Registry record updated Jul 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
6401005446 Issued in MI
Practice address
520 Superior St
Port Huron, MI 48060-3838
Phone
(810) 984-4202
NPI assigned
Aug 29, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801034906 MI
Professional Counselor 101YP2500X 6401005446 MI
Mental Health Counselor 101YM0800X 6401005446 MI Primary

Addresses

Primary practice location

520 Superior St
Port Huron, MI 48060-3838

Mailing address

230 Huron Ave
Port Huron, MI 48060-3822
Phone (810) 966-4471

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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

Enrollment IDStateProvider typePAC IDDetails
I20240304001426 MI Practitioner - Mental Health Counselor 3173968898 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6401005446MIMDProfessional Counselor
6801034906MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
St Clair County Community Mental Health Authority Past Accepting new patients

Organizations & group practices 2

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": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720569600000",
    "number": "1376652941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 HURON AVE",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480603822",
            "telephone_number": "810-966-4471",
            "fax_number": "810-985-9448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 SUPERIOR ST",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480603838",
            "telephone_number": "810-984-4202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRKLAND",
        "first_name": "THURMOND",
        "name_prefix": "Mr.",
        "credential": "LPC, LMSW, QMRP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801034906",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401005446",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6401005446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Huron, MI

Sources for this page

Verify at the official NPI Registry.