Provider Demographics
NPI:1114692050
Name:THORNBERRY, SARAH BROOKE (MSW, LSW)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:BROOKE
Last Name:THORNBERRY
Suffix:
Gender:F
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5493 LIBERTY WOODS DR
Mailing Address - Street 2:
Mailing Address - City:LIBERTY TWP
Mailing Address - State:OH
Mailing Address - Zip Code:45011-9793
Mailing Address - Country:US
Mailing Address - Phone:210-773-2113
Mailing Address - Fax:
Practice Address - Street 1:4030 OXFORD REILY RD
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:OH
Practice Address - Zip Code:45056-8943
Practice Address - Country:US
Practice Address - Phone:513-273-3300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-12
Last Update Date:2021-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.2106631104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker