Individual provider Active NPI

Louise Oast Thornton, LCSW

  • Clinical Social Worker
  • Fort Myers, FL
National Provider Identifier
1356444962
Registry record updated Jun 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW15696 Issued in FL
Practice address
4310 Metro Pkwy Ste 205
Fort Myers, FL 33916-9416
Phone
(239) 223-2751
Fax
(239) 561-2933
NPI assigned
Sep 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW15696 FL Primary

Addresses

Primary practice location

4310 Metro Pkwy Ste 205
Fort Myers, FL 33916-9416

Mailing address

305 1/2 W Venice Ave Apt 6
Venice, FL 34285-2051
Phone (757) 390-0213

Other identifiers 1

IdentifierTypeStateIssuer
010023351MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW15696FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Personal Growth & Change PastSince Oct 1, 2020 Accepting new patients
Evergreen Behavioral Management Inc Clinical Past Accepting new patients
Psychiatric Services, P.C. Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592265600000",
    "number": "1356444962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 1/2 W VENICE AVE APT 6",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342852051",
            "telephone_number": "757-390-0213",
            "fax_number": "757-425-1389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4310 METRO PKWY STE 205",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339169416",
            "telephone_number": "239-223-2751",
            "fax_number": "239-561-2933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THORNTON",
        "first_name": "LOUISE",
        "middle_name": "OAST",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-07",
        "last_updated": "2020-06-16",
        "certification_date": "2020-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW15696",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010023351",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.