Healthcare Provider Details

I. General information

NPI: 1427976943
Provider Name (Legal Business Name): FAITH THORNTON LLMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/10/2026
Last Update Date: 07/10/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4920 PLAINFIELD AVE NE STE A
GRAND RAPIDS MI
49525-1010
US

IV. Provider business mailing address

418 ALLEN ST
IONIA MI
48846-1302
US

V. Phone/Fax

Practice location:
  • Phone: 616-232-5081
  • Fax:
Mailing address:
  • Phone: 616-232-5081
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6851121614
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: