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General NPI Number Information
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NPI Number | 1093277147
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Entity Type | Individual
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Provider Name | KAITLIN SUE THURSTON
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Gender | Female
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Dates
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Enumeration Date | 04/05/2019
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Last Update Date | 10/07/2025
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Provider Practice Location Address
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Address Line | 6701 DEMOCRACY BLVD
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City | BETHESDA
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State | MD
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Zip | 20817-1572
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Country | US
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Telephone | 800-249-1266
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Fax |
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Provider Business Mailing Address
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Address Line | 14440 CHERRY LANE CT STE 208
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City | LAUREL
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State | MD
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Zip | 20707-4946
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Country | US
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Telephone | 301-604-1458
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Fax | 301-604-1459
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 31544
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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