Active NPI
Kristen Sarah Thomas, MS, LLP, LPCC
- Clinical Psychologist
- Livonia, MI
National Provider Identifier
1912053174
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 6301012278
- Practice address
- 38875 Lyndon St
Livonia, MI 48154 - Phone
- (734) 673-9190
- NPI assigned
- Jan 28, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | CC00084 | MN | |
| Clinical Psychologist | 103TC0700X | 6301012278 | MI | Primary |
Addresses
Primary practice location
38875 Lyndon St
Livonia, MI 48154
Mailing address
1481 S Trail Cir
Faribault, MN 55021-7071
Phone (734) 673-9190
Other practice location 1
1481 S Trail Cir
Faribault, MN 55021-7071
Phone (734) 673-9190
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912053174 | Other | MN | MEDICAL ASSISTANCE (MA) |
| 1912053174 | Other | MN | BLUE CROSS BLUE SHIELD |
| 1912053174 | Other | MN | HEALTH PARTNERS |
Other names 1
- Ms. Kristen Sarah McClellan
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CC00084 | MN | MD | Professional Counselor |
| 6301012278 | MI | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169942400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1531353600000",
"number": "1912053174",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1481 S TRAIL CIR",
"city": "FARIBAULT",
"state": "MN",
"postal_code": "550217071",
"telephone_number": "734-673-9190"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "38875 LYNDON ST",
"city": "LIVONIA",
"state": "MI",
"postal_code": "48154",
"telephone_number": "734-673-9190"
}
],
"practiceLocations": [
{
"address_1": "1481 S Trail Cir",
"address_purpose": "LOCATION",
"city": "Faribault",
"state": "MN",
"postal_code": "550217071",
"country_code": "US",
"telephone_number": "734-673-9190",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "THOMAS",
"first_name": "KRISTEN",
"middle_name": "SARAH",
"name_prefix": "Ms.",
"credential": "MS, LLP, LPCC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-28",
"last_updated": "2018-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MN",
"license": "CC00084",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MI",
"license": "6301012278",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL ASSISTANCE (MA)",
"identifier": "1912053174",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "1912053174",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PARTNERS",
"identifier": "1912053174",
"state": "MN"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "KRISTEN",
"last_name": "MCCLELLAN",
"middle_name": "SARAH",
"prefix": "MS.",
"credential": "MS, LLP",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Livonia, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.