Healthcare Provider Details

I. General information

NPI: 1699246116
Provider Name (Legal Business Name): THRIVE COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2018
Last Update Date: 12/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1705 WOODLAND ST NE
WARREN OH
44483-5348
US

IV. Provider business mailing address

1705 WOODLAND ST NE
WARREN OH
44483-5348
US

V. Phone/Fax

Practice location:
  • Phone: 330-469-6777
  • Fax:
Mailing address:
  • Phone: 330-469-6777
  • 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: ANGEL OLIVIA PIXLEY
Title or Position: CO OWNER
Credential:
Phone: 330-984-2129