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General NPI Number Information
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NPI Number | 1144715772
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Entity Type | Organization
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Legal Business Name | GOING TO THRIVE LLC
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Dates
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Enumeration Date | 06/26/2018
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Last Update Date | 06/26/2018
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Provider Practice Location Address
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Address Line | 312 WYNDHURST AVE FL 2
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City | BALTIMORE
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State | MD
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Zip | 21210-2416
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Country | US
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Telephone | 443-904-4615
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Fax |
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Provider Business Mailing Address
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Address Line | 3721 REXMERE RD
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City | BALTIMORE
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State | MD
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Zip | 21218-2011
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LAUREN GOING
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Credential |
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Telephone | 443-904-4615
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 14358
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License Number State | MD
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