Healthcare Provider Details

I. General information

NPI: 1710803531
Provider Name (Legal Business Name): MOUNTAIN THRIVE COUNSELING PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8665 W 78TH PL
ARVADA CO
80005-4313
US

IV. Provider business mailing address

8665 W 78TH PL
ARVADA CO
80005-4313
US

V. Phone/Fax

Practice location:
  • Phone: 720-675-8259
  • Fax:
Mailing address:
  • Phone: 510-689-3725
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: CHARLES MAYER-TWOMEY
Title or Position: OWNER
Credential: LCSW
Phone: 510-689-3725