Individual provider Active NPI

Connie Sue Thomas, LMFT

  • Marriage & Family Therapist
  • Orange, CA
National Provider Identifier
1598109779
Registry record updated Apr 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT42408 Issued in CA
Practice address
1529 W Culver Ave Apt 16
Orange, CA 92868-4150
Phone
(714) 371-7954
NPI assigned
Apr 18, 2013
Last updated
Apr 18, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 18, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X LMFT42408 CA Primary
Marriage & Family Therapist 106H00000X MFT1033 CO

Addresses

Primary practice location

1529 W Culver Ave Apt 16
Orange, CA 92868-4150

Mailing address

1529 W Culver Ave Apt 16
Orange, CA 92868-4150
Phone (714) 371-7954

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20250311003903 CA Practitioner - Marriage and Family Therapist 0042731614 Practice locations: Tustin, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LMFT42408CAMDMarriage & Family Therapist
MFT1033COMDMarriage & Family Therapist
42408CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Connie S. Thomas, LMFT Marriage & Family Therapist CurrentSince Apr 11, 2021 Accepting new patients

Locations

12821 Newport Ave
Tustin, CA 92780
Phone (714) 803-4866

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1366243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366243200000",
    "number": "1598109779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1529 W CULVER AVE APT 16",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684150",
            "telephone_number": "714-371-7954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1529 W CULVER AVE APT 16",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684150",
            "telephone_number": "714-371-7954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "CONNIE",
        "middle_name": "SUE",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-18",
        "last_updated": "2013-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT42408",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CO",
            "license": "MFT1033",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.