Provider Demographics
NPI:1093250698
Name:THIGPEN, JOHN MONSTRE (MSW, SUDP, LICSW)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:MONSTRE
Last Name:THIGPEN
Suffix:
Gender:M
Credentials:MSW, SUDP, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9633 LEVIN RD NW
Mailing Address - Street 2:
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98383-8131
Mailing Address - Country:US
Mailing Address - Phone:360-698-5883
Mailing Address - Fax:360-782-9586
Practice Address - Street 1:3888 NW RANDALL WAY STE 201
Practice Address - Street 2:
Practice Address - City:SILVERDALE
Practice Address - State:WA
Practice Address - Zip Code:98383-7847
Practice Address - Country:US
Practice Address - Phone:360-698-5883
Practice Address - Fax:360-809-6002
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-05
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACP60494074101YA0400X
WALW609018011041C0700X
1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2153701Medicaid