Active NPI
Thomas D Kirk, MA, LPC, PHD
- Professional Counselor
- Cheyenne, WY
National Provider Identifier
1578735940
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC 483
- Practice address
- 2600 E 18TH St
Cheyenne, WY 82001-5511 - Phone
- (307) 633-7254
- NPI assigned
- Mar 26, 2008
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC 483 | WY | Primary |
Addresses
Primary practice location
2600 E 18TH St
Cheyenne, WY 82001-5511
Mailing address
214 E 23Rd St
Cheyenne, WY 82001-3748
Phone (307) 633-3096
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)
- Enrolled
- Credentials
- Master of Arts, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC 483 | WY | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1206489600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1372118400000",
"number": "1578735940",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "214 E 23RD ST",
"city": "CHEYENNE",
"state": "WY",
"postal_code": "820013748",
"telephone_number": "307-633-3096"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2600 E 18TH ST",
"city": "CHEYENNE",
"state": "WY",
"postal_code": "820015511",
"telephone_number": "307-633-7254"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIRK",
"first_name": "THOMAS",
"middle_name": "D",
"credential": "MA, LPC, PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-03-26",
"last_updated": "2013-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "WY",
"license": "LPC 483",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cheyenne, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.