Provider Demographics
NPI:1639711302
Name:THORNE, ANGELIA HELEN (LPC)
Entity Type:Individual
Prefix:
First Name:ANGELIA
Middle Name:HELEN
Last Name:THORNE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 W FRANKLIN RD STE I
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83642-2992
Mailing Address - Country:US
Mailing Address - Phone:208-600-9207
Mailing Address - Fax:
Practice Address - Street 1:40 W FRANKLIN RD STE I
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83642-2992
Practice Address - Country:US
Practice Address - Phone:208-600-9207
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-14
Last Update Date:2021-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLPC-6914101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health