Provider Demographics
NPI:1407224520
Name:THORNDIKE, KATHLEEN LAMBERT (LICSW)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:LAMBERT
Last Name:THORNDIKE
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:KATHLEEN
Other - Middle Name:THERESE
Other - Last Name:LAMBERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW
Mailing Address - Street 1:1342 FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-4907
Mailing Address - Country:US
Mailing Address - Phone:360-510-4807
Mailing Address - Fax:
Practice Address - Street 1:2901 SQUALICUM PKWY
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-1851
Practice Address - Country:US
Practice Address - Phone:360-510-4807
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-04
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW603890921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical