Provider Demographics
NPI:1104049261
Name:THORNTON, LINDA M (MA, LPC)
Entity type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:M
Last Name:THORNTON
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20125 HARBOR LN
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48076-4910
Mailing Address - Country:US
Mailing Address - Phone:313-537-7230
Mailing Address - Fax:
Practice Address - Street 1:26520 GRAND RIVER AVE. SUITE 107
Practice Address - Street 2:
Practice Address - City:REDFORD
Practice Address - State:MI
Practice Address - Zip Code:48240
Practice Address - Country:US
Practice Address - Phone:313-537-7230
Practice Address - Fax:313-537-1866
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2014-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401008086101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional