Healthcare Provider Details

I. General information

NPI: 1710892039
Provider Name (Legal Business Name): THRIVELY CO. NJ COUNSELING & COACHING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

181 NEW RD STE 304
PARSIPPANY NJ
07054-5625
US

IV. Provider business mailing address

181 NEW RD STE 304
PARSIPPANY NJ
07054-5625
US

V. Phone/Fax

Practice location:
  • Phone: 201-571-6826
  • Fax:
Mailing address:
  • Phone: 201-571-6826
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: SHANNON THEOBALD
Title or Position: CEO
Credential: MA, LPC
Phone: 201-571-6826