Michael Ray Throneberry, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

40963 Issued in TX

Practice address

1814 8TH Ave
Fort Worth, TX 76110-1354

Phone

(214) 415-7093

NPI assigned

Sep 21, 2017

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 TX

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

Specialty

Clinical Social Worker

Education

Other, 2004

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1505952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662768000000",
    "number": "1710496781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4620 CLOUDVIEW RD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761093326",
            "telephone_number": "214-415-7093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1814 8TH AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761101354",
            "telephone_number": "214-415-7093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THRONEBERRY",
        "first_name": "MICHAEL",
        "middle_name": "RAY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-09-21",
        "last_updated": "2022-09-10",
        "certification_date": "2022-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "40963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thousand Hands Inc
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• Thrive in-Home Rehab, LLC
• Thrivewell Home Health LLC
• Throne Room (Trim)
• Madison Belle Thurman
• Scott A Thurman, MD
• Tracy Thurmond
• Miekka Estelle Thye, M.S., CCC/SLP
• Daniel Tiblets

• Clinical Social Worker in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.