MEDICARE: TO THRIVE COUNSELING AND CONSULTING, 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
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1922849538
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TO THRIVE COUNSELING AND CONSULTING, LLC

Provider Business Mailing Address
First Line	:	7331 S OLYMPIA AVE
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74132-1849
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7413 W 39TH ST
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74107-4865
Country	:	US
Telephone Number	:	918-200-9732
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	NEDA ALLAM
Credential	:
Telephone Number	:	918-200-9732

Provider Enumeration Date	:	06/06/2024
Last Update Date	:	06/06/2024

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