Healthcare Provider Details

I. General information

NPI: 1952016776
Provider Name (Legal Business Name): KACEY THIGPEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/16/2023
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3443 ESPLANADE AVE APT 502
NEW ORLEANS LA
70119-2962
US

IV. Provider business mailing address

3443 ESPLANADE AVE APT 502
NEW ORLEANS LA
70119-2962
US

V. Phone/Fax

Practice location:
  • Phone: 910-289-7711
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number15709
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: