Provider Demographics
NPI:1821499146
Name:THORNTON, SARAH (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:THORNTON
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 N GORE AVE
Mailing Address - Street 2:SUITE 204
Mailing Address - City:WEBSTER GROVES
Mailing Address - State:MO
Mailing Address - Zip Code:63119-2315
Mailing Address - Country:US
Mailing Address - Phone:314-200-4464
Mailing Address - Fax:
Practice Address - Street 1:16 N GORE AVE
Practice Address - Street 2:SUITE 204
Practice Address - City:WEBSTER GROVES
Practice Address - State:MO
Practice Address - Zip Code:63119-2315
Practice Address - Country:US
Practice Address - Phone:314-200-4464
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-05
Last Update Date:2014-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20040118891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical