Healthcare Provider Details

I. General information

NPI: 1760386031
Provider Name (Legal Business Name): THRIVEWELL THERAPY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2026
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 LAHINCH CIR
RICHARDSON TX
75081-5140
US

IV. Provider business mailing address

901 LAHINCH CIR
RICHARDSON TX
75081-5140
US

V. Phone/Fax

Practice location:
  • Phone: 763-300-0707
  • Fax:
Mailing address:
  • Phone: 763-300-0707
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. JOO HYUNG KIM
Title or Position: OWNER
Credential: LCSW, LICSW, MSW
Phone: 763-300-0707