Provider Demographics
NPI:1316622731
Name:THORNE, COTINA (LCMHC-A)
Entity type:Individual
Prefix:
First Name:COTINA
Middle Name:
Last Name:THORNE
Suffix:
Gender:F
Credentials:LCMHC-A
Other - Prefix:
Other - First Name:COTINA
Other - Middle Name:
Other - Last Name:THORNE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:108 REMINGTON DR
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27804-9004
Mailing Address - Country:US
Mailing Address - Phone:252-544-3303
Mailing Address - Fax:
Practice Address - Street 1:108 REMINGTON DR
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27804-9004
Practice Address - Country:US
Practice Address - Phone:252-544-3303
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-21
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA18571101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional