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General NPI Number Information
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NPI Number | 1467967711
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Entity Type | Organization
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Legal Business Name | THRIVE WELLNESS COUNSELING, LLC
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Dates
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Enumeration Date | 12/08/2017
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Last Update Date | 12/08/2017
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Provider Practice Location Address
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Address Line | 79050 US HWY 40
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City | WINTER PARK
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State | CO
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Zip | 80482
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Country | US
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Telephone | 970-531-7537
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 415
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City | TABERNASH
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State | CO
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Zip | 80478-0415
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | COLLEEN DAVIS-TIMMS
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Credential |
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Telephone | 970-531-7537
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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 | ACB7798
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License Number State | CO
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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 | LPC.0013935
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License Number State | CO
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Taxonomy #3
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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 | CO
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