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General NPI Number Information
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NPI Number | 1396185070
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Entity Type | Organization
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Legal Business Name | THRIVE POSTPARTUM, COUPLES AND FAMILY THERAPY, LLC
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Dates
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Enumeration Date | 06/26/2013
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Last Update Date | 10/28/2019
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Provider Practice Location Address
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Address Line | 2500 W HIGGINS RD STE 570
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City | HOFFMAN ESTATES
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State | IL
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Zip | 60169
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Country | US
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Telephone | 224-698-9792
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Fax |
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Provider Business Mailing Address
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Address Line | 2500 W HIGGINS RD STE 570
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City | HOFFMAN ESTATES
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State | IL
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Zip | 60169-7210
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Country | US
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Telephone | 224-698-9792
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Fax |
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Authorized Official
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Title or Position | OWNER/DIRECTOR
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Name | SUMA KARANDIKAR
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Credential | LCPC
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Telephone | 224-698-9792
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 149015629
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License Number State | IL
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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 | 180005433
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License Number State | IL
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