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General NPI Number Information
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NPI Number | 1376333484
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Entity Type | Organization
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Legal Business Name | THRIVE COUNSELING OF KENTUCKY LLC
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Dates
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Enumeration Date | 05/12/2025
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Last Update Date | 05/12/2025
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Provider Practice Location Address
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Address Line | 1809 GRIMES AVE
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City | OWENSBORO
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State | KY
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Zip | 42303-0902
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Country | US
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Telephone | 270-302-1907
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Fax |
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Provider Business Mailing Address
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Address Line | 1809 GRIMES AVE
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City | OWENSBORO
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State | KY
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Zip | 42303-0902
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Country | US
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Telephone | 270-302-1907
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Fax |
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Authorized Official
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Title or Position | PROGRAM SUPERVISOR
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Name | LONNIE LYLES
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Credential | LCSW,
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Telephone | 270-791-8550
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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