=====================================================
General NPI Number Information
=====================================================
NPI Number | 1205794765
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SURVIVOR TO THRIVER
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/13/2026
-----------------------------------------------------
Last Update Date | 01/13/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1720 I ST NW
-----------------------------------------------------
City | WASHINGTON
-----------------------------------------------------
State | DC
-----------------------------------------------------
Zip | 20006-3704
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 571-268-0258
-----------------------------------------------------
Fax | 202-217-2397
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2813 TOLES PARK DR
-----------------------------------------------------
City | SUITLAND
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20746-1611
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 571-268-0258
-----------------------------------------------------
Fax | 202-217-2397
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | CORDELIA CRANSHAW
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 571-268-0258
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------