Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 15871-132 | WI |
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 899 | GA |
Y | 101YM0800X | Mental Health Counselor | 3746-226 | WI |
N | 225XM0800X | Mental Health |
NPI | 1871013227 |
---|---|
Provider Name | Sheme Thorns |
First Address | Milwaukee, WI 53224-2302 |
Second Address | Stone Mountain, GA 30087-4212 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2017 |
Last Update Date | 12/04/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100073940 | (05) | WI |