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General NPI Number Information
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NPI Number | 1841668506
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Entity Type | Organization
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Legal Business Name | CHARTRICE THORNE
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Dates
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Enumeration Date | 09/10/2015
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Last Update Date | 11/03/2016
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Provider Practice Location Address
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Address Line | 8527 MAYLAND DR SUITE 103
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City | HENRICO
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State | VA
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Zip | 23294-4753
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Country | US
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Telephone | 804-363-2583
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Fax | 804-510-0244
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Provider Business Mailing Address
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Address Line | 8527 MAYLAND DR SUITE 103
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City | HENRICO
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State | VA
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Zip | 23294-4753
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Country | US
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Telephone | 804-363-2583
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Fax | 804-510-0244
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Authorized Official
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Title or Position | SOLE PROPRIETOR
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Name | CHARTRICE THORNE
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Credential |
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Telephone | 804-370-7819
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 0904008871
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 0904008871
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License Number State | VA
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