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General NPI Number Information
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NPI Number | 1811711658
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Entity Type | Organization
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Legal Business Name | THRIVE THERAPY AND OUTREACH, LLC
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Dates
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Enumeration Date | 11/08/2024
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Last Update Date | 11/08/2024
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Provider Practice Location Address
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Address Line | 510 MAIN AVE
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City | BROOKINGS
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State | SD
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Zip | 57006-2048
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Country | US
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Telephone | 605-691-1516
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Fax |
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Provider Business Mailing Address
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Address Line | 1706 1ST ST
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City | BROOKINGS
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State | SD
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Zip | 57006-2619
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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 | OWNER
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Name | RHIANNON NEDLAND
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Credential | LPC-MH
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Telephone | 605-691-1516
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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