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General NPI Number Information
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NPI Number | 1508728486
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Entity Type | Organization
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Legal Business Name | SPECTHRIVE WELLNESS & BEHAVIORAL HEALTH LLC
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Dates
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Enumeration Date | 11/29/2025
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Last Update Date | 11/29/2025
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Provider Practice Location Address
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Address Line | 7100 NORTHLAND CIR N STE 104-H
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City | BROOKLYN PARK
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State | MN
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Zip | 55428-1548
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Country | US
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Telephone | 612-208-6549
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Fax |
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Provider Business Mailing Address
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Address Line | 7960 ORCHID LN N
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City | MAPLE GROVE
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State | MN
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Zip | 55311-2186
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Country | US
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Telephone | 612-807-0456
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Fax |
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Authorized Official
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Title or Position | THERAPIST/COUNSELOR
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Name | NANCY NYABUTI
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Credential | MA
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Telephone | 612-807-0456
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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