Provider Demographics
NPI:1689493843
Name:THORNE, CASI (MA)
Entity type:Individual
Prefix:
First Name:CASI
Middle Name:
Last Name:THORNE
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 1:4204 SW GREEN OAKS BLVD STE 120
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76017-4159
Mailing Address - Country:US
Mailing Address - Phone:817-721-7426
Mailing Address - Fax:817-687-7012
Practice Address - Street 1:4204 SW GREEN OAKS BLVD STE 120
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76017-4159
Practice Address - Country:US
Practice Address - Phone:817-721-7426
Practice Address - Fax:817-687-7012
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-05
Last Update Date:2024-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX96408101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health