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General NPI Number Information
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NPI Number | 1255159653
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Entity Type | Organization
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Legal Business Name | THRIVING KIDS BEHAVIORAL SERVICES, INC.
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Dates
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Enumeration Date | 10/03/2024
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Last Update Date | 10/07/2024
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Provider Practice Location Address
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Address Line | 24225 W 9 MILE RD STE 280
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City | SOUTHFIELD
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State | MI
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Zip | 48033-6708
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Country | US
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Telephone | 248-876-0175
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Fax |
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Provider Business Mailing Address
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Address Line | 24225 W 9 MILE RD STE 280
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City | SOUTHFIELD
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State | MI
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Zip | 48033-6708
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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 | EXECUTIVE DIRECTOR
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Name | CHANELLE REEVES
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Credential |
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Telephone | 517-528-8886
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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