Provider Demographics
NPI:1558692251
Name:THATCHER, THORA L (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:THORA
Middle Name:L
Last Name:THATCHER
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 1:6092 FRANCONIA RD
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22310-1741
Mailing Address - Country:US
Mailing Address - Phone:703-922-0443
Mailing Address - Fax:703-922-0603
Practice Address - Street 1:6092 FRANCONIA RD
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22310-1741
Practice Address - Country:US
Practice Address - Phone:703-922-0443
Practice Address - Fax:703-922-0603
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-19
Last Update Date:2010-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040072991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical