MEDICARE: THRIVE THERAPY NORTHWEST, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1457156382
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THRIVE THERAPY NORTHWEST, PLLC

Provider Business Mailing Address
First Line	:	1417 NW 54TH ST STE 316
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98107-3573
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1417 NW 54TH ST STE 316
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98107-3573
Country	:	US
Telephone Number	:	425-270-8761
Fax Number	:

Authorized Official
Title or Position	:	OWNER/MENTAL HEALTH COUNSELOR
Name	:	MUIRENN LEINSTER
Credential	:	MA, LMHC
Telephone Number	:	206-518-0719

Provider Enumeration Date	:	02/14/2025
Last Update Date	:	02/14/2025

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