Provider Demographics
NPI:1053004978
Name:THORNTON, LUKAS EVERETTE (MSW)
Entity type:Individual
Prefix:
First Name:LUKAS
Middle Name:EVERETTE
Last Name:THORNTON
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:SUMMER
Other - Middle Name:ANN
Other - Last Name:THORNTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1010 EASTERN TRL APT 203
Mailing Address - Street 2:
Mailing Address - City:MUKWONAGO
Mailing Address - State:WI
Mailing Address - Zip Code:53149-1063
Mailing Address - Country:US
Mailing Address - Phone:920-784-9384
Mailing Address - Fax:
Practice Address - Street 1:514 RIVERVIEW AVE
Practice Address - Street 2:
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53188-3631
Practice Address - Country:US
Practice Address - Phone:262-548-8224
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-26
Last Update Date:2025-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst