Healthcare Provider Details

I. General information

NPI: 1124951702
Provider Name (Legal Business Name): THORNTON THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2026
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 S DEARBORN ST APT 1603
CHICAGO IL
60605-1834
US

IV. Provider business mailing address

600 S DEARBORN ST APT 1603
CHICAGO IL
60605-1834
US

V. Phone/Fax

Practice location:
  • Phone: 503-504-5886
  • Fax:
Mailing address:
  • Phone: 503-504-5886
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: GRACE THORNTON
Title or Position: LCPC
Credential: LPC
Phone: 503-504-5886