MEDICARE: THRIVE MENTORING AND COUNSELING

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	:	1881010726
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THRIVE MENTORING AND COUNSELING

Provider Business Mailing Address
First Line	:	2626 S LOOP W STE 650C
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77054-5628
Country	:	US
Telephone Number	:	713-377-6954
Fax Number	:

Provider Business Practice Location Address
First Line	:	1317 VERNAGE RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77047-3237
Country	:	US
Telephone Number	:	713-377-6954
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MRS. KATRINA EDWARDS
Credential	:
Telephone Number	:	713-377-6954

Provider Enumeration Date	:	03/17/2014
Last Update Date	:	04/04/2016

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Directions to “THRIVE MENTORING AND COUNSELING ” Practice Location

Language	Start Address	Practice Location

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