Provider Demographics
NPI:1548542095
Name:THORNTON, NAOMI S (LCSW)
Entity type:Individual
Prefix:
First Name:NAOMI
Middle Name:S
Last Name:THORNTON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 KENSINGTON AVE STE 211A
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59801-5670
Mailing Address - Country:US
Mailing Address - Phone:406-544-1278
Mailing Address - Fax:406-552-4877
Practice Address - Street 1:800 KENSINGTON AVE STE 211A
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59801-5670
Practice Address - Country:US
Practice Address - Phone:406-544-1278
Practice Address - Fax:406-552-4877
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-11
Last Update Date:2016-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT10161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical