Provider Demographics
NPI:1265878029
Name:THORNTON, CURTIS ALAN (LMSW, CAADC, CCS)
Entity type:Individual
Prefix:
First Name:CURTIS
Middle Name:ALAN
Last Name:THORNTON
Suffix:
Gender:M
Credentials:LMSW, CAADC, CCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3115 PROFESSIONAL DR
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48104-5131
Mailing Address - Country:US
Mailing Address - Phone:734-975-1602
Mailing Address - Fax:734-975-1604
Practice Address - Street 1:3115 PROFESSIONAL DR
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48104-5131
Practice Address - Country:US
Practice Address - Phone:734-975-1602
Practice Address - Fax:734-975-1604
Is Sole Proprietor?:No
Enumeration Date:2013-05-20
Last Update Date:2019-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010872661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical