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General NPI Number Information
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NPI Number | 1770184251
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Entity Type | Organization
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Legal Business Name | THINK TO THRIVE PSYCHOLOGICAL SERVICES PLLC
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Dates
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Enumeration Date | 11/03/2020
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Last Update Date | 11/03/2020
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Provider Practice Location Address
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Address Line | 16250 NORTHLAND DR STE 204B
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City | SOUTHFIELD
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State | MI
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Zip | 48075-5205
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Country | US
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Telephone | 415-336-7707
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Fax |
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Provider Business Mailing Address
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Address Line | 3070 WHISPERWOOD DR APT 417
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City | ANN ARBOR
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State | MI
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Zip | 48105-3419
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Country | US
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Telephone | 415-336-7707
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | DR. DANTE DEMITRIUS DIXSON
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Credential | PHD
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Telephone | 415-336-7707
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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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 | 103TS0200X
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Taxonomy Name | School 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 | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number |
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License Number State |
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