Provider Demographics
NPI:1861532566
Name:THORNE, PATRICIA MILLER (LCSW)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:MILLER
Last Name:THORNE
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 1:1400 SEAFARER DR
Mailing Address - Street 2:
Mailing Address - City:ORIENTAL
Mailing Address - State:NC
Mailing Address - Zip Code:28571-9651
Mailing Address - Country:US
Mailing Address - Phone:434-392-5005
Mailing Address - Fax:
Practice Address - Street 1:1400 SEAFARER DR
Practice Address - Street 2:
Practice Address - City:ORIENTAL
Practice Address - State:NC
Practice Address - Zip Code:28571-9651
Practice Address - Country:US
Practice Address - Phone:434-392-5005
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2024-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW00036151041C0700X
VA09040067231041C0700X
NCC0159541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical