Provider Demographics
NPI:1508222605
Name:THORN, LINDA (LCPC-C)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:THORN
Suffix:
Gender:F
Credentials:LCPC-C
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:O
Other - Last Name:MONKMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:41 DEPOT ST STE 1A
Mailing Address - Street 2:
Mailing Address - City:BRIDGTON
Mailing Address - State:ME
Mailing Address - Zip Code:04009-1298
Mailing Address - Country:US
Mailing Address - Phone:207-894-4830
Mailing Address - Fax:
Practice Address - Street 1:41 DEPOT ST STE 1A
Practice Address - Street 2:
Practice Address - City:BRIDGTON
Practice Address - State:ME
Practice Address - Zip Code:04009-1298
Practice Address - Country:US
Practice Address - Phone:207-894-4830
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-06
Last Update Date:2019-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEXL4342101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional