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General NPI Number Information
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NPI Number | 1558418178
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Entity Type | Individual
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Provider Name | PHILIP ANDREW THORN L.C.P.C.
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Gender | Male
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Dates
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Enumeration Date | 01/04/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 603 POST OFFICE RD
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City | WALDORF
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State | MD
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Zip | 20602-1914
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Country | US
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Telephone | 301-705-7593
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Fax | 301-705-8753
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Provider Business Mailing Address
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Address Line | 13930 MOUNT EAGLE LN
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City | WALDORF
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State | MD
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Zip | 20601-4264
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Country | US
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Telephone | 301-843-0004
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Fax | 301-705-8753
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LC0011
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LC0011
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License Number State | MD
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