Thomas David Klopfenstein, MSW LCSW LCAC

Primary specialty

Social WorkerTaxonomy code 104100000X

License

34004597A Issued in IN

Practice address

310 N Michigan St
Suite 208
Plymouth, IN 46563-1770

Phone

(574) 935-9449

Fax

(574) 935-3956

NPI assigned

Aug 31, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1125446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295481600000",
    "number": "1790778124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 N MICHIGAN ST",
            "address_2": "SUITE 208",
            "city": "PLYMOUTH",
            "state": "IN",
            "postal_code": "465631770",
            "telephone_number": "574-935-9449",
            "fax_number": "574-935-3956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 N MICHIGAN ST",
            "address_2": "SUITE 208",
            "city": "PLYMOUTH",
            "state": "IN",
            "postal_code": "465631770",
            "telephone_number": "574-935-9449",
            "fax_number": "574-935-3956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLOPFENSTEIN",
        "first_name": "THOMAS",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "MSW LCSW LCAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-31",
        "last_updated": "2011-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IN",
            "license": "34004597A",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IN",
            "license": "87000150A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100114180",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200095080A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sabeen Khan, MD
• Austin Kimble
• Sara Marie King, MSW, LCSW
• Julia Kinney
• Brandon Kleckner
• Grant Nicholas Kolbe, MSED
• Jerry Kralovansky, O.D.
• Lindsay McKay Kreps, NP-C
• David John Krizman, M.D.
• Kroger Limited Partnership I

• All providers in Plymouth, IN
• Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2011; 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.