Healthcare Provider Details

I. General information

NPI: 1487383808
Provider Name (Legal Business Name): THRIVE PSYCHOLOGICAL AND CONSULTING SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2022
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 WILSON AVE RM 330
MENOMONIE WI
54751-2746
US

IV. Provider business mailing address

800 WILSON AVE RM 330
MENOMONIE WI
54751-2746
US

V. Phone/Fax

Practice location:
  • Phone: 715-256-7166
  • Fax:
Mailing address:
  • Phone: 715-256-7166
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: TONYA KLEM
Title or Position: OWNER/FOUNDER
Credential:
Phone: 715-256-7166