Provider Demographics
NPI:1346872702
Name:THORNE, ALEXIS MARIE (LMSW)
Entity Type:Individual
Prefix:MISS
First Name:ALEXIS
Middle Name:MARIE
Last Name:THORNE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:MISS
Other - First Name:ALEXIS
Other - Middle Name:MARIE
Other - Last Name:THORNE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMSW
Mailing Address - Street 1:100 PINEWILD DR STE 2A
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14606-4200
Mailing Address - Country:US
Mailing Address - Phone:585-368-3700
Mailing Address - Fax:585-368-6767
Practice Address - Street 1:100 PINEWILD DR STE 2A
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14606-4200
Practice Address - Country:US
Practice Address - Phone:585-368-3700
Practice Address - Fax:585-368-6767
Is Sole Proprietor?:No
Enumeration Date:2020-02-04
Last Update Date:2020-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY103869104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker