Christian Thibeault

Primary specialty

Social WorkerTaxonomy code 104100000X

Practice address

1695 Main St FL 400
Springfield, MA 01103-1063

Phone

(413) 739-5572

NPI assigned

Jun 21, 2015

Sex

Male

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

Enrolled in MA

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• The Brien Center for Mental Health and Substance Abuse Services Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Pittsfield, MA
  • NPI 1518984251
  Medicare reassignment NPD
• Community Services Institute, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Springfield, MA
  • NPI 1255450631
  NPD (past)

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

{
    "created_epoch": "1434844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434844800000",
    "number": "1699157131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 BOG HOLLOW RD",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011091420",
            "telephone_number": "518-337-8182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1695 MAIN ST FL 400",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011031063",
            "telephone_number": "413-739-5572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIBEAULT",
        "first_name": "CHRISTIAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-21",
        "last_updated": "2015-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cheryl Ann Theroux, OTR
• Dianne Theroux
• Michelle Nicole Theroux, LMHC
• Emily Rose Thibaud
• Tania Thibault
• Amanda Nicole Thibodeau
• Kimberly S Thieme
• Anay Thodge, MD
• Amy Lynne Thomas Crisafulli, LICSW
• Angela Thomas-Lefebvre, NP-C

• Social Worker in Springfield, MA
• Providers in Springfield, MA by specialty
• Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2015; 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.