MEDICARE: LORI THORNTON

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	101YP2500X	Professional Counselor	3523	TN

General Provider Information

NPI Number	:	1457668097
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LORI THORNTON

Provider Business Mailing Address
First Line	:	1224A COLUMBIA AVE
Second Line	:
City	:	FRANKLIN
State	:	TN
Zip	:	37064-3619
Country	:	US
Telephone Number	:	615-818-7002
Fax Number	:

Provider Business Practice Location Address
First Line	:	6009 PENBROOK DR
Second Line	:
City	:	FRANKLIN
State	:	TN
Zip	:	37069-8406
Country	:	US
Telephone Number	:	615-818-7002
Fax Number	:

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

Provider Enumeration Date	:	09/02/2010
Last Update Date	:	08/16/2016

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Directions to “ LORI THORNTON ” Practice Location

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