Provider Demographics
NPI:1518934785
Name:THORP, HEATHER A (LCSW)
Entity Type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:A
Last Name:THORP
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:161 EASTWOOD BND
Mailing Address - Street 2:
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28607-8148
Mailing Address - Country:US
Mailing Address - Phone:828-268-0301
Mailing Address - Fax:
Practice Address - Street 1:895 STATE FARM RD
Practice Address - Street 2:SUITE 104
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607-4917
Practice Address - Country:US
Practice Address - Phone:828-265-0190
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-07
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0044931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCD0775OtherMEDCOST
NC135TEOtherBCBS OF NC
NC231878OtherUNITED BEHAVIORAL HEALTH
NC6003600Medicaid
NC2178792OtherCIGNA BEHAVIORAL HEALTH
NC2877307Medicare ID - Type UnspecifiedPROVIDER ID #