Provider Demographics
NPI:1306431366
Name:THRIVE COUNSELING TELETHERAPY SERVICES LLC
Entity type:Organization
Organization Name:THRIVE COUNSELING TELETHERAPY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NEKIA
Authorized Official - Middle Name:Y
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:202-669-6577
Mailing Address - Street 1:5557 BALTIMORE AVE STE 500
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20781-1922
Mailing Address - Country:US
Mailing Address - Phone:202-669-6577
Mailing Address - Fax:301-779-0500
Practice Address - Street 1:1715 HART CT
Practice Address - Street 2:
Practice Address - City:CROFTON
Practice Address - State:MD
Practice Address - Zip Code:21114-1630
Practice Address - Country:US
Practice Address - Phone:443-808-1577
Practice Address - Fax:301-779-0500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-02
Last Update Date:2021-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty