Krystal Thorburn, MSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

44SC05691400 Issued in NJ

Practice address

8251 E Blackwillow Cir Apt 104
Anaheim, CA 92808-2903

Phone

(908) 798-9780

NPI assigned

Jun 7, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Serene Counseling Licensed Clinical Social Worker Corporation

  • Clinical Social Worker
  • Tustin, CA
  • NPI 1033049440
  NPD Authorized official
• Los Angeles LGBT Center

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
  • NPI 1225599178
  NPD
• Los Angeles LGBT Center

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
  • NPI 1548298532

  Clinical

  NPD

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

{
    "created_epoch": "1465257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688083200000",
    "number": "1629427976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8251 E BLACKWILLOW CIR APT 104",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928082903",
            "telephone_number": "908-798-9780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8251 E BLACKWILLOW CIR APT 104",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928082903",
            "telephone_number": "908-798-9780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THORBURN",
        "first_name": "KRYSTAL",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-07",
        "last_updated": "2023-06-30",
        "certification_date": "2023-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05691400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sahikellie Tyler Thompson
• Tamara Dawn Thompson, PHARMD
• Tristan Thompson
• Tyeka Thompson
• Jihann M Thoney, NP
• Lorraine Thornburg, L.P.C.C.
• Sara Christine Thornton
• Jennifer Thorpe, PA
• Thrifty Payless Inc
• Thrifty Payless Inc

• Clinical Social Worker in Anaheim, CA
• Providers in Anaheim, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.