Healthcare Provider Details

I. General information

NPI: 1487591376
Provider Name (Legal Business Name): AMANDA ELAINE THORNE CADC, MHRT/C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2026
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 CALDWELL RD
AUGUSTA ME
04330-5735
US

IV. Provider business mailing address

10 CALDWELL RD
AUGUSTA ME
04330-5735
US

V. Phone/Fax

Practice location:
  • Phone: 207-626-3448
  • Fax: 207-626-3453
Mailing address:
  • Phone: 207-626-3448
  • Fax: 207-626-3453

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCAC9403
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: