MEDICARE: HEATHER MARTIN THORNBERRY LPCC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	290760	KY
2	101YP2500X	Professional Counselor	E.2606494	OH

General Provider Information

NPI Number	:	1285072900
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEATHER MARTIN THORNBERRY LPCC

Provider Business Mailing Address
First Line	:	4800 N SCOTTSDALE RD STE 2500
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85251-7630
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1077 STATE ROUTE 28 STE 202
Second Line	:
City	:	MILFORD
State	:	OH
Zip	:	45150-4000
Country	:	US
Telephone Number	:	216-468-5000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/05/2013
Last Update Date	:	03/10/2026

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Directions to “ HEATHER MARTIN THORNBERRY LPCC” Practice Location

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