Provider Demographics
NPI:1417789439
Name:THRIVEPOINT COUNSELING AND BEHAVIORAL HEALTH LLC
Entity type:Organization
Organization Name:THRIVEPOINT COUNSELING AND BEHAVIORAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LMSW, BCBA, LBA
Authorized Official - Prefix:MRS
Authorized Official - First Name:SALLY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW, LBA
Authorized Official - Phone:616-209-4435
Mailing Address - Street 1:19 RADNY DR
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:MI
Mailing Address - Zip Code:49331-9131
Mailing Address - Country:US
Mailing Address - Phone:616-209-4435
Mailing Address - Fax:
Practice Address - Street 1:318 E MAIN ST STE A
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MI
Practice Address - Zip Code:49331-1734
Practice Address - Country:US
Practice Address - Phone:616-209-4435
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-19
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty