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General NPI Number Information
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NPI Number | 1922618800
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Entity Type | Organization
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Legal Business Name | THRIVE COUNSELING & WELLNESS PC
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Dates
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Enumeration Date | 08/05/2020
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Last Update Date | 08/02/2024
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Provider Practice Location Address
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Address Line | 255 N BUFFALO GROVE RD UNIT 7844
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City | BUFFALO GROVE
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State | IL
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Zip | 60089-8587
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Country | US
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Telephone | 224-434-9176
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Fax |
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Provider Business Mailing Address
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Address Line | 70 STINSON PL
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City | CASTLE PINES
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State | CO
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Zip | 80108-4024
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Country | US
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Telephone | 847-845-9149
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JENNIFER L LANG
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Credential | LCPC
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Telephone | 224-434-9176
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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