NPI Code Details Logo

NPI 1629995584

NPI 1629995584 : THRIVE FAMILY COUNSELING, LLC : ST CHARLES, IL

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1629995584
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    THRIVE FAMILY COUNSELING, LLC 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    07/01/2026
-----------------------------------------------------
    Last Update Date     |    07/01/2026
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    1503 KEIM CT 
-----------------------------------------------------
    City                 |    ST CHARLES
-----------------------------------------------------
    State                |    IL
-----------------------------------------------------
    Zip                  |    60174-5819
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    630-747-6156
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    1503 KEIM CT 
-----------------------------------------------------
    City                 |    ST CHARLES
-----------------------------------------------------
    State                |    IL
-----------------------------------------------------
    Zip                  |    60174-5819
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    630-747-6156
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    OWNER
-----------------------------------------------------
    Name                 |     SIMONE  SHEPARDSON 
-----------------------------------------------------
    Credential           |    LCPC
-----------------------------------------------------
    Telephone            |    630-747-6156
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    101YM0800X
-----------------------------------------------------
    Taxonomy Name        |    Mental Health Counselor
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.