Provider Demographics
NPI:1629283221
Name:THORNTON, MELISSA LAYNE (MBA, LMFT)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:LAYNE
Last Name:THORNTON
Suffix:
Gender:F
Credentials:MBA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 POPLAR ST
Mailing Address - Street 2:
Mailing Address - City:TRUMBULL
Mailing Address - State:CT
Mailing Address - Zip Code:06611-3034
Mailing Address - Country:US
Mailing Address - Phone:203-268-5437
Mailing Address - Fax:
Practice Address - Street 1:5 POPLAR ST
Practice Address - Street 2:
Practice Address - City:TRUMBULL
Practice Address - State:CT
Practice Address - Zip Code:06611-3034
Practice Address - Country:US
Practice Address - Phone:203-268-5437
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0457106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist