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NPI Code Detail

MEDICARE: THRIVE COUNSELING AND WELLNESS, PLLC

MEDICARE: THRIVE COUNSELING AND WELLNESS, PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family Therapist
2101YP2500XProfessional Counselor
31041C0700XClinical Social Worker
4101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1871003269
Entity Type Code : Organization
Provider Name (Legal Business Name) : THRIVE COUNSELING AND WELLNESS, PLLC
Provider Business Mailing Address
First Line : 311 WILLIAMSON RD STE 103
Second Line :
City : MOORESVILLE
State : NC
Zip : 28117-5967
Country : US
Telephone Number : 704-360-3049
Fax Number : 704-973-9588
Provider Business Practice Location Address
First Line : 311 WILLIAMSON RD STE 103
Second Line :
City : MOORESVILLE
State : NC
Zip : 28117-5967
Country : US
Telephone Number : 704-756-0058
Fax Number :
Authorized Official
Title or Position : OWNER
Name : CRYSTAL NICOLE HULETT
Credential : LMFT
Telephone Number : 704-756-0058
Provider Enumeration Date : 10/11/2017
Last Update Date : 03/23/2021

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