Healthcare Provider Details

I. General information

NPI: 1023720828
Provider Name (Legal Business Name): THRIVE CONSULTING P.L.L.C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/23/2022
Last Update Date: 12/23/2022
Certification Date: 12/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15129 QUAIL HOLLOW DR APT 302
ORLAND PARK IL
60462-4080
US

IV. Provider business mailing address

15129 QUAIL HOLLOW DR APT 302
ORLAND PARK IL
60462-4080
US

V. Phone/Fax

Practice location:
  • Phone: 708-560-5373
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: JENELLE HOYT
Title or Position: CEO
Credential: LCPC
Phone: 708-560-5373