Provider Demographics
NPI:1841668506
Name:CHARTRICE THORNE
Entity type:Organization
Organization Name:CHARTRICE THORNE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:CHARTRICE
Authorized Official - Middle Name:
Authorized Official - Last Name:THORNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-370-7819
Mailing Address - Street 1:8527 MAYLAND DR
Mailing Address - Street 2:SUITE 103
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23294-4753
Mailing Address - Country:US
Mailing Address - Phone:804-363-2583
Mailing Address - Fax:804-510-0244
Practice Address - Street 1:8527 MAYLAND DR
Practice Address - Street 2:SUITE 103
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23294-4753
Practice Address - Country:US
Practice Address - Phone:804-363-2583
Practice Address - Fax:804-510-0244
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-10
Last Update Date:2016-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0904008871251S00000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty