Provider Demographics
NPI: | 1518934785 |
---|---|
Name: | THORP, HEATHER A (LCSW) |
Entity type: | Individual |
Prefix: | MS |
First Name: | HEATHER |
Middle Name: | A |
Last Name: | THORP |
Suffix: | |
Gender: | F |
Credentials: | LCSW |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 161 EASTWOOD BND |
Mailing Address - Street 2: | |
Mailing Address - City: | BOONE |
Mailing Address - State: | NC |
Mailing Address - Zip Code: | 28607-8148 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 828-268-0301 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 161 EASTWOOD BND |
Practice Address - Street 2: | |
Practice Address - City: | BOONE |
Practice Address - State: | NC |
Practice Address - Zip Code: | 28607-8148 |
Practice Address - Country: | US |
Practice Address - Phone: | 828-406-9686 |
Practice Address - Fax: | |
Is Sole Proprietor?: | Yes |
Enumeration Date: | 2006-03-07 |
Last Update Date: | 2025-05-27 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
NC | C004493 | 1041C0700X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 1041C0700X | Behavioral Health & Social Service Providers | Social Worker | Clinical |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
NC | D0775 | Other | MEDCOST |
NC | 135TE | Other | BCBS OF NC |
NC | 6003600 | Medicaid | |
NC | 2178792 | Other | CIGNA BEHAVIORAL HEALTH |
NC | 231878 | Other | UNITED BEHAVIORAL HEALTH |
NC | 2877307 | Medicare ID - Type Unspecified | PROVIDER ID # |