Individual provider Active NPI

Kentrell Thomas, BSW

  • Mental Health Counselor
  • Decatur, AL
National Provider Identifier
1407201700
Registry record updated Apr 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
4110 US Highway 31 S
Decatur, AL 35603-1644
Phone
(256) 260-1691
Fax
(256) 341-0747
NPI assigned
Apr 25, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

4110 US Highway 31 S
Decatur, AL 35603-1644

Mailing address

1316 Somerville Rd SE
Suite 1
Decatur, AL 35601-4305
Phone (256) 260-7361

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20260625000228 AL Practitioner - Clinical Social Worker 9830662410 Practice locations: Moundville, AL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

Moundville, AL 35474
Phone (256) 384-5510

825 6TH Ave S
Apt 767
Nashville, TN 37203-7581

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Health Center of North Central Alabama Inc. PastSince May 6, 1996 Accepting new patients
Mental Health Center of North Central Alabama 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": "1461542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461542400000",
    "number": "1407201700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1316 SOMERVILLE RD SE",
            "address_2": "SUITE 1",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356014305",
            "telephone_number": "256-260-7361",
            "fax_number": "256-341-0747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4110 US HIGHWAY 31 S",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356031644",
            "telephone_number": "256-260-1691",
            "fax_number": "256-341-0747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "KENTRELL",
        "credential": "BSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-25",
        "last_updated": "2016-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, AL

Sources for this page

Verify at the official NPI Registry.