Healthcare Provider Details

I. General information

NPI: 1396185070
Provider Name (Legal Business Name): THRIVE POSTPARTUM, COUPLES AND FAMILY THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2013
Last Update Date: 10/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 W HIGGINS RD STE 570
HOFFMAN ESTATES IL
60169
US

IV. Provider business mailing address

2500 W HIGGINS RD STE 570
HOFFMAN ESTATES IL
60169-7210
US

V. Phone/Fax

Practice location:
  • Phone: 224-698-9792
  • Fax:
Mailing address:
  • Phone: 224-698-9792
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149015629
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number180005433
License Number StateIL

VIII. Authorized Official

Name: SUMA KARANDIKAR
Title or Position: OWNER/DIRECTOR
Credential: LCPC
Phone: 224-698-9792