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General NPI Number Information
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NPI Number | 1154183267
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Entity Type | Organization
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Legal Business Name | THRIVING SPARROW COUNSELING & WELLNESS, PLLC
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Dates
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Enumeration Date | 01/24/2024
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Last Update Date | 01/14/2025
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Provider Practice Location Address
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Address Line | 5320 W ELM ST
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City | MCHENRY
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State | IL
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Zip | 60050-4029
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Country | US
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Telephone | 815-200-8520
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Fax |
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Provider Business Mailing Address
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Address Line | 256 STONEGATE RD
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City | TROUT VALLEY
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State | IL
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Zip | 60013-2524
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Country | US
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Telephone | 815-529-5933
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JENNIFER ANN ROCHON
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Credential |
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Telephone | 815-529-5933
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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