Provider Demographics
NPI:1912155912
Name:THORNETT, WILLIAM DARREN (LPC, LMHC)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:DARREN
Last Name:THORNETT
Suffix:
Gender:M
Credentials:LPC, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:747 JENKS AVE STE D
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32401-2570
Mailing Address - Country:US
Mailing Address - Phone:850-866-2630
Mailing Address - Fax:
Practice Address - Street 1:747 JENKS AVE STE D
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32401-2570
Practice Address - Country:US
Practice Address - Phone:850-866-2630
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-03
Last Update Date:2020-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALC1505A101YP2500X
FLMH17611101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional