Provider Demographics
NPI:1205660487
Name:THORNTON, MAURICE (EDD)
Entity type:Individual
Prefix:DR
First Name:MAURICE
Middle Name:
Last Name:THORNTON
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5200 JAY ST NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20019-5528
Mailing Address - Country:US
Mailing Address - Phone:202-378-3243
Mailing Address - Fax:
Practice Address - Street 1:13854 CARTER HOUSE WAY
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-4855
Practice Address - Country:US
Practice Address - Phone:301-346-5047
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-29
Last Update Date:2024-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health