Healthcare Provider Details

I. General information

NPI: 1871411124
Provider Name (Legal Business Name): THRIVE WITHIN THERAPY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5228 S DREXEL AVE APT 3W
CHICAGO IL
60615-3737
US

IV. Provider business mailing address

1821 W HUBBARD ST STE 209 PMB 556
CHICAGO IL
60622-6273
US

V. Phone/Fax

Practice location:
  • Phone: 815-763-6899
  • Fax:
Mailing address:
  • Phone: 815-763-6899
  • 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: MISS BIANCA TAYLOR
Title or Position: OWNER/MANAGING MEMBER
Credential: LCSW
Phone: 815-763-6899