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General NPI Number Information
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NPI Number | 1114406253
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Entity Type | Organization
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Legal Business Name | THRIVING ON PURPOSE
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Dates
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Enumeration Date | 08/09/2018
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Last Update Date | 08/09/2018
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Provider Practice Location Address
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Address Line | 8201 ARROWRIDGE BLVD
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City | CHARLOTTE
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State | NC
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Zip | 28273-5865
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Country | US
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Telephone | 704-705-6029
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Fax |
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Provider Business Mailing Address
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Address Line | 2805 EDWIN JONES DR
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City | CHARLOTTE
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State | NC
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Zip | 28269-8331
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Country | US
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Telephone | 704-705-6029
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Fax |
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Authorized Official
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Title or Position | OWNER/CLINICAL DIRECTOR
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Name | MONICA MCNEILL
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Credential | LPC
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Telephone | 704-705-6029
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 10867
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License Number State | NC
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