Provider Demographics
NPI:1861839037
Name:THORNE, REBECCA L (LPC)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:L
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 1:501 MANTOOTH AVE
Mailing Address - Street 2:
Mailing Address - City:LUFKIN
Mailing Address - State:TX
Mailing Address - Zip Code:75904-3014
Mailing Address - Country:US
Mailing Address - Phone:936-639-4993
Mailing Address - Fax:
Practice Address - Street 1:501 MANTOOTH AVE
Practice Address - Street 2:
Practice Address - City:LUFKIN
Practice Address - State:TX
Practice Address - Zip Code:75904-3014
Practice Address - Country:US
Practice Address - Phone:936-639-4993
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-29
Last Update Date:2013-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11664101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional