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General NPI Number Information
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NPI Number | 1407251341
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Entity Type | Organization
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Legal Business Name | THRIVE PSYCHOTHERAPY AND CONSULTING SERVICES LLC
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Dates
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Enumeration Date | 11/04/2014
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Last Update Date | 11/04/2014
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Provider Practice Location Address
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Address Line | 219 SCOTT ST # 128
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City | BEAUFORT
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State | SC
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Zip | 29902-5554
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Country | US
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Telephone | 843-694-1528
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Fax |
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Provider Business Mailing Address
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Address Line | 219 SCOTT ST # 128
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City | BEAUFORT
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State | SC
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Zip | 29902-5554
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Country | US
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Telephone | 843-694-1528
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Fax |
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Authorized Official
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Title or Position | OWNER AND ADMINISTRATOR
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Name | JEFFREY DOYNE FAILING
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Credential | MHA
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Telephone | 843-694-1528
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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