Individual
KIMBERLY LAUREN THORNTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
4855 S MOORLAND RD STE 250, NEW BERLIN, WI 53151-7494
(262) 789-6020
(262) 789-6025
Mailing address
3737 LANDER RD, PEPPER PIKE, OH 44124-5712
(216) 831-2255
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
218457
MA
1041C0700X
Clinical Social Worker
Primary
218457
WI
1041C0700X
Clinical Social Worker
I.1501309
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1861795684
NPI
—
05
—
2871101
—
OH
Enumeration date
12/16/2010
Last updated
06/13/2023
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