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General NPI Number Information
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NPI Number | 1356971634
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Entity Type | Organization
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Legal Business Name | THRIVE COUNSELING, PLLC
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Dates
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Enumeration Date | 01/25/2020
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Last Update Date | 01/23/2023
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Provider Practice Location Address
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Address Line | 370 COURTHOUSE RD STE 102
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City | GULFPORT
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State | MS
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Zip | 39507-1889
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Country | US
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Telephone | 228-395-8378
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Fax | 228-604-8016
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Provider Business Mailing Address
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Address Line | 370 COURTHOUSE RD STE 102
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City | GULFPORT
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State | MS
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Zip | 39507-1889
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Country | US
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Telephone | 228-395-8378
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Fax | 228-604-8016
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Authorized Official
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Title or Position | OWNER/ LPC
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Name | DESTINIE WEEMS
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Credential | LPC
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Telephone | 228-395-8378
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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 |
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License Number State |
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