Healthcare Provider Details

I. General information

NPI: 1982970885
Provider Name (Legal Business Name): KATHERINE I. THONIS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2012
Last Update Date: 09/27/2021
Certification Date: 09/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 COMMERCIAL ST SUITE # 1012 B
MANCHESTER NH
03101-1142
US

IV. Provider business mailing address

250 COMMERCIAL ST STE 211
MANCHESTER NH
03101-1142
US

V. Phone/Fax

Practice location:
  • Phone: 603-801-2732
  • Fax: 603-206-5621
Mailing address:
  • Phone: 603-801-2732
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number1242
License Number StateNH

VIII. Authorized Official

Name: KATHERINE I THONIS
Title or Position: LSCW
Credential:
Phone: 603-801-2732