Healthcare Provider Details
I. General information
NPI: 1255129516
Provider Name (Legal Business Name): THRIVING FAMILIES PSYCHOLOGICAL SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/28/2025
Last Update Date: 04/28/2025
Certification Date: 04/07/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
383 FISHER RD
GROSSE POINTE MI
48230-1674
US
IV. Provider business mailing address
31925 STAMAN CT
FARMINGTON HILLS MI
48336-1867
US
V. Phone/Fax
- Phone: 313-444-2630
- Fax:
- Phone: 313-444-2630
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TC2200X |
| Taxonomy | Clinical Child & Adolescent Psychologist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TF0000X |
| Taxonomy | Family Psychologist |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
TIFFANY
ABREGO
Title or Position: OWNER
Credential: PHD
Phone: 313-444-2630