Provider Demographics
NPI:1568299428
Name:THORNTON, NIANI (LCSW,CSSWS)
Entity type:Individual
Prefix:
First Name:NIANI
Middle Name:
Last Name:THORNTON
Suffix:
Gender:F
Credentials:LCSW,CSSWS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36197 GREENLEAF CT
Mailing Address - Street 2:
Mailing Address - City:PRAIRIEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70769-3375
Mailing Address - Country:US
Mailing Address - Phone:225-802-7755
Mailing Address - Fax:
Practice Address - Street 1:36197 GREENLEAF CT
Practice Address - Street 2:
Practice Address - City:PRAIRIEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70769-3375
Practice Address - Country:US
Practice Address - Phone:225-802-7755
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-16
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA53681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical