Healthcare Provider Details

I. General information

NPI: 1639522485
Provider Name (Legal Business Name): THRIVE COUNSELING & CONSULTATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2016
Last Update Date: 09/18/2024
Certification Date: 09/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 REDWING DR
WINCHESTER KY
40391-1633
US

IV. Provider business mailing address

301 BOONE AVE
WINCHESTER KY
40391-2374
US

V. Phone/Fax

Practice location:
  • Phone: 859-737-0904
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: DAVID CARTER
Title or Position: BILLING MANAGER
Credential:
Phone: 859-737-0904