Provider Demographics
NPI:1285789503
Name:THORNE, FREDERICK WILLIAM (BA, CSW)
Entity type:Individual
Prefix:MR
First Name:FREDERICK
Middle Name:WILLIAM
Last Name:THORNE
Suffix:
Gender:M
Credentials:BA, CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:309 WALTER AVE
Mailing Address - Street 2:
Mailing Address - City:DELANCO
Mailing Address - State:NJ
Mailing Address - Zip Code:08075-4335
Mailing Address - Country:US
Mailing Address - Phone:856-461-1926
Mailing Address - Fax:856-461-1964
Practice Address - Street 1:25 IKEA DRIVE
Practice Address - Street 2:
Practice Address - City:WESTAMPTON
Practice Address - State:NJ
Practice Address - Zip Code:08060-5115
Practice Address - Country:US
Practice Address - Phone:609-267-9339
Practice Address - Fax:609-267-6655
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SW00232000104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker