Provider Demographics
NPI:1982426441
Name:THRIVE AND WELLNESS THERAPY LLC
Entity type:Organization
Organization Name:THRIVE AND WELLNESS THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIERSTEN
Authorized Official - Middle Name:
Authorized Official - Last Name:LIPINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-C
Authorized Official - Phone:574-993-2820
Mailing Address - Street 1:917 SAINT MICHAEL DR
Mailing Address - Street 2:
Mailing Address - City:GAMBRILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21054-1635
Mailing Address - Country:US
Mailing Address - Phone:574-993-2820
Mailing Address - Fax:
Practice Address - Street 1:917 SAINT MICHAEL DR
Practice Address - Street 2:
Practice Address - City:GAMBRILLS
Practice Address - State:MD
Practice Address - Zip Code:21054-1635
Practice Address - Country:US
Practice Address - Phone:574-993-2820
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-28
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty