Provider Demographics
NPI:1043658156
Name:THORNTON, KIMBERLY L (MA)
Entity type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:L
Last Name:THORNTON
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 HIGH RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:NEW KENSINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15068-1763
Mailing Address - Country:US
Mailing Address - Phone:412-365-5811
Mailing Address - Fax:
Practice Address - Street 1:6031 SALTSBURG RD
Practice Address - Street 2:
Practice Address - City:VERONA
Practice Address - State:PA
Practice Address - Zip Code:15147-3315
Practice Address - Country:US
Practice Address - Phone:412-365-5811
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-11
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC009648101Y00000X
101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor