Healthcare Provider Details

I. General information

NPI: 1235716226
Provider Name (Legal Business Name): THRIVE UNBURDENED, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2021
Last Update Date: 07/24/2023
Certification Date: 07/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1389 ENTRANCE RD STE F
LEESVILLE LA
71446-8820
US

IV. Provider business mailing address

3300 ARCTIC BLVD STE 201 #1005
ANCHORAGE AK
99503-1182
US

V. Phone/Fax

Practice location:
  • Phone: 337-221-4596
  • Fax:
Mailing address:
  • Phone: 561-601-6345
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: DANIELLE PLUVIOSE
Title or Position: BILLING MANAGER
Credential:
Phone: 561-425-9059