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General NPI Number Information
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NPI Number | 1447633151
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Entity Type | Organization
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Legal Business Name | THRIVE COMMUNITY SERVICES
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Dates
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Enumeration Date | 06/30/2015
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Last Update Date | 03/04/2021
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Provider Practice Location Address
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Address Line | 111 CLYDE ST
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City | BENNETTSVILLE
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State | SC
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Zip | 29512-3117
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Country | US
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Telephone | 843-353-8934
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Fax |
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Provider Business Mailing Address
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Address Line | 1026 CLINARD AVE
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City | HIGH POINT
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State | NC
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Zip | 27265-3142
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Country | US
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Telephone | 843-353-8934
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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 | VANESSA DENISE QUICK
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Credential |
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Telephone | 843-353-8934
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) 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 | 103TA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Psychologist
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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 | 103TP2701X
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Taxonomy Name | Group Psychotherapy Psychologist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #6
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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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Taxonomy #7
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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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