Provider Demographics
NPI:1982182366
Name:THORNTON, DEBRA JANE (NCC , LPC)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:JANE
Last Name:THORNTON
Suffix:
Gender:F
Credentials:NCC , LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12915 JASMINE CT
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80602-7898
Mailing Address - Country:US
Mailing Address - Phone:210-643-5628
Mailing Address - Fax:
Practice Address - Street 1:12915 JASMINE CT
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80602-7898
Practice Address - Country:US
Practice Address - Phone:210-643-5628
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-30
Last Update Date:2018-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0014226101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional