Provider Demographics
NPI:1043491939
Name:THAYNE CONSULTING
Entity type:Organization
Organization Name:THAYNE CONSULTING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:ELAINE
Authorized Official - Last Name:THAYNE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:801-427-2607
Mailing Address - Street 1:3051 W MAPLE LOOP DR STE 200
Mailing Address - Street 2:
Mailing Address - City:LEHI
Mailing Address - State:UT
Mailing Address - Zip Code:84043-4602
Mailing Address - Country:US
Mailing Address - Phone:801-427-2607
Mailing Address - Fax:
Practice Address - Street 1:3051 W MAPLE LOOP DR STE 200
Practice Address - Street 2:
Practice Address - City:LEHI
Practice Address - State:UT
Practice Address - Zip Code:84043-4602
Practice Address - Country:US
Practice Address - Phone:801-427-2607
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-19
Last Update Date:2007-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT34967235011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT1467515932OtherNPI INDIVIDUAL