Kenneth C Thunberg, PH D

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

048-0000875 Issued in VT

Practice address

70 S Winooski Ave
Suite 288
Burlington, VT 05401-3898

Phone

(802) 651-9700

Fax

(210) 615-2279

NPI assigned

Aug 8, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Deer Oaks New England, LLC

  • Clinical Psychologist
  • Burlington, VT
  • NPI 1275798076
  NPD (past)
• Deer Oaks Mental Health Associates PC

  • Clinical Psychologist
  • Las Cruces, NM
  • NPI 1134175763
  NPD (past)

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203984000000",
    "number": "1689684029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7272 WURZBACH RD",
            "address_2": "SUITE 601",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782404801",
            "telephone_number": "210-615-8880",
            "fax_number": "210-615-2279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 S WINOOSKI AVE",
            "address_2": "SUITE 288",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054013898",
            "telephone_number": "802-651-9700",
            "fax_number": "210-615-2279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THUNBERG",
        "first_name": "KENNETH",
        "middle_name": "C",
        "credential": "PH D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2008-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VT",
            "license": "048-0000875",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0VN3913",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexandra Harding Thomsen, PH.D.
• Katrina Thornburgh
• Brennan M Thornton
• Kirsten J. Threlkeld, MD
• Thrive Pelvic Wellness (Lifetime Wellness and Yoga)
• Jiayu Kate Tian, MD
• Sean Daniel Till, MD
• Tiffany Dawn Tillman, MA
• Linda Lee Tilton, RD, CDE
• Tiffany Amy Ting, MD

• Clinical Psychologist in Burlington, VT
• Providers in Burlington, VT by specialty
• Clinical Psychologist in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2008; 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.