Individual provider Active NPI

Philip Andrew Thorn, L.C.P.C.

  • Mental Health Counselor
  • Waldorf, MD
National Provider Identifier
1558418178
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LC0011 Issued in MD
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

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
LC0011MDMDMental 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.

Verify at the official NPI Registry.