Provider Demographics
NPI:1154832871
Name:THORNE, STACI C (LCSWA)
Entity type:Individual
Prefix:
First Name:STACI
Middle Name:C
Last Name:THORNE
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:STACI
Other - Middle Name:C
Other - Last Name:BROWNLEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSWA
Mailing Address - Street 1:2501 BRAGG BLVD
Mailing Address - Street 2:STE A, PMB #135
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28303
Mailing Address - Country:US
Mailing Address - Phone:910-849-0401
Mailing Address - Fax:
Practice Address - Street 1:2501 BRAGG BLVD STE A
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28303-4141
Practice Address - Country:US
Practice Address - Phone:910-849-0401
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-20
Last Update Date:2025-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
NCP0160831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical