Richard Louis Thibault Jr.

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

11 Circle Ave
Lynn, MA 01905-3050

Phone

(781) 595-2413

Fax

(781) 596-0113

NPI assigned

Aug 22, 2019

Last updated

Aug 22, 2019By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1566432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566432000000",
    "number": "1750938940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 WINTER ST APT 9",
            "city": "SALEM",
            "state": "MA",
            "postal_code": "019703865",
            "telephone_number": "978-786-2788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 CIRCLE AVE",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "019053050",
            "telephone_number": "781-595-2413",
            "fax_number": "781-596-0113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIBAULT",
        "first_name": "RICHARD",
        "middle_name": "LOUIS",
        "name_suffix": "Jr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-08-22",
        "last_updated": "2019-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tova Teperow, OTR/L
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• Jared C Thomas, LMT,CPT
• Sameer Thompson-Massoom
• Barbara Thompson

• Addiction (Substance Use Disorder) Counselor in Lynn, MA
• Providers in Lynn, MA by specialty
• Addiction (Substance Use Disorder) Counselor in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2019; 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.