Active NPI
Philip Andrew Thorn, L.C.P.C.
- Mental Health Counselor
- Waldorf, MD
National Provider Identifier
1558418178
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- LC0011
- Practice address
- 603 Post Office Rd
Waldorf, MD 20602-1914 - Phone
- (301) 705-7593
- Fax
- (301) 705-8753
- NPI assigned
- Jan 4, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | LC0011 | MD | Primary |
| Professional Counselor | 101YP2500X | LC0011 | MD |
Addresses
Primary practice location
603 Post Office Rd
Waldorf, MD 20602-1914
Mailing address
13930 Mount Eagle LN
Waldorf, MD 20601-4264
Phone (301) 843-0004
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 |
|---|---|---|---|
| LC0011 | MD | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167868800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1558418178",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13930 MOUNT EAGLE LN",
"city": "WALDORF",
"state": "MD",
"postal_code": "206014264",
"telephone_number": "301-843-0004",
"fax_number": "301-705-8753"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "603 POST OFFICE RD",
"city": "WALDORF",
"state": "MD",
"postal_code": "206021914",
"telephone_number": "301-705-7593",
"fax_number": "301-705-8753"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THORN",
"first_name": "PHILIP",
"middle_name": "ANDREW",
"name_prefix": "Dr.",
"credential": "L.C.P.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-04",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MD",
"license": "LC0011",
"primary": true
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MD",
"license": "LC0011",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Waldorf, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.