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NPI Code Detail

MEDICARE: ANNA CATHERINE THORNTON LCMHCA

MEDICARE: ANNA CATHERINE THORNTON LCMHCA
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
1101YM0800XMental Health CounselorA18350NC

General Provider Information

NPI Number : 1578275897
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANNA CATHERINE THORNTON LCMHCA
Provider Business Mailing Address
First Line : 4641 GENERAL PERSHING DR
Second Line :
City : CHARLOTTE
State : NC
Zip : 28209-2809
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 10706 SIKES PL STE 275
Second Line :
City : CHARLOTTE
State : NC
Zip : 28277-8015
Country : US
Telephone Number : 704-577-4071
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/19/2022
Last Update Date : 12/19/2022

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