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NPI Code Detail

MEDICARE: THRIVE COUNSELING SERVICES, LLC

MEDICARE: THRIVE COUNSELING SERVICES, LLC
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
11041C0700XClinical Social Worker

General Provider Information

NPI Number : 1457876237
Entity Type Code : Organization
Provider Name (Legal Business Name) : THRIVE COUNSELING SERVICES, LLC
Provider Business Mailing Address
First Line : PO BOX 531
Second Line :
City : FRENCHTOWN
State : MT
Zip : 59834-0531
Country : US
Telephone Number : 406-529-0287
Fax Number :
Provider Business Practice Location Address
First Line : 16840 BECKWITH ST STE 12
Second Line :
City : FRENCHTOWN
State : MT
Zip : 59834-9646
Country : US
Telephone Number : 406-529-0287
Fax Number :
Authorized Official
Title or Position : THERAPIST
Name : MS. JANETTE ELLIS
Credential : LCSW
Telephone Number : 406-529-0287
Provider Enumeration Date : 08/14/2017
Last Update Date : 09/09/2017

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