Healthcare Provider Details

I. General information

NPI: 1093646838
Provider Name (Legal Business Name): ERICA THORNHILL CT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

915 CROGHAN ST
FREMONT OH
43420-2337
US

IV. Provider business mailing address

915 CROGHAN ST
FREMONT OH
43420-2337
US

V. Phone/Fax

Practice location:
  • Phone: 419-458-3100
  • Fax:
Mailing address:
  • Phone: 937-561-2337
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberC-2507345-TRNE
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: