Provider Demographics
NPI:1659816809
Name:THORNTON, KADE (PHD)
Entity type:Individual
Prefix:
First Name:KADE
Middle Name:
Last Name:THORNTON
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1775 FORRESTAL DR BLDG NEW
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23551-2400
Mailing Address - Country:US
Mailing Address - Phone:757-836-1552
Mailing Address - Fax:
Practice Address - Street 1:1775 FORRESTAL DR BLDG NEW
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23551-2400
Practice Address - Country:US
Practice Address - Phone:757-836-1552
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-27
Last Update Date:2025-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810008697103TC0700X
174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical