Individual
TRAVIS THORNTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
2280 E 25TH ST, IDAHO FALLS, ID 83404-7542
(208) 227-2377
Mailing address
155 CRIMSON DR, IDAHO FALLS, ID 83401-3714
(208) 589-3628
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-42551
ID
1041C0700X
Clinical Social Worker
SWB-2026-0071
NM
Other
Enumeration date
03/28/2017
Last updated
01/30/2026
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