Provider Demographics
NPI:1578058178
Name:THORNTON, BEVERLY J (LMFT)
Entity Type:Individual
Prefix:MS
First Name:BEVERLY
Middle Name:J
Last Name:THORNTON
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:998 FARMINGTON AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06107-2187
Mailing Address - Country:US
Mailing Address - Phone:860-614-8875
Mailing Address - Fax:860-614-8875
Practice Address - Street 1:998 FARMINGTON AVE STE 201
Practice Address - Street 2:
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06107-2187
Practice Address - Country:US
Practice Address - Phone:860-952-9070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-26
Last Update Date:2018-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT2003106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist