Kristine Joy Thoresen, LICSW, DCSW

Individual provider Active NPI Clinical Social Worker · Barnstable, MA

NPI 1972643971 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1972643971
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
1015859 (MA)
Practice address
275 Millway
Barnstable, MA 02630-1102
Phone
(508) 362-4416
NPI assigned
Feb 7, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 1015859 MA Yes

Addresses

Primary practice location

275 Millway
Barnstable, MA 02630-1102

Mailing address

275 Millway
P.O. Box 312
Barnstable, MA 02630-1102
Phone (508) 362-4416

Other identifiers

IdentifierTypeStateIssuer
007775OtherMAPACIFIC CARE PROVIDER #
760845OtherMATUFTS PROVIDER NUMBER
PO4675OtherMABC BS PROVIDER NUMBER
008278OtherMAVALUE OPTIONS PROVIDER #
1891910OtherMAMBHP PROVIDER NUMBER
358812OtherMAMAGELLAN PROVIDER NUMBER

Other providers in Barnstable, MA

All providers in Barnstable, MA · Clinical Social Worker in Massachusetts

Sources for this page

Verify at the official NPI Registry.