Healthcare Provider Details

I. General information

NPI: 1922207810
Provider Name (Legal Business Name): CRAIG R THORNHILL MA LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2007
Last Update Date: 01/22/2020
Certification Date: 01/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

810 LINCOLN AVE # 200
STEAMBOAT SPRINGS CO
80487-4972
US

IV. Provider business mailing address

PO BOX 770147
STEAMBOAT SPRINGS CO
80477-0147
US

V. Phone/Fax

Practice location:
  • Phone: 970-871-6811
  • Fax: 970-871-6811
Mailing address:
  • Phone: 970-879-7637
  • Fax: 970-987-1681

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number949
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC 4480
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: