Provider Demographics
NPI:1033622659
Name:THRIVE COUNSELING AND CONSULTING SERVICES MARRIAGE AND FAMILY THERAPY
Entity Type:Organization
Organization Name:THRIVE COUNSELING AND CONSULTING SERVICES MARRIAGE AND FAMILY THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:BATTAGLIA
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT 86123
Authorized Official - Phone:408-410-4461
Mailing Address - Street 1:45445 PORTOLA AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:PALM DESERT
Mailing Address - State:CA
Mailing Address - Zip Code:92260-4844
Mailing Address - Country:US
Mailing Address - Phone:760-895-1466
Mailing Address - Fax:760-610-1160
Practice Address - Street 1:45445 PORTOLA AVE STE 1
Practice Address - Street 2:
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92260-4844
Practice Address - Country:US
Practice Address - Phone:760-895-1466
Practice Address - Fax:760-610-1160
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-06
Last Update Date:2017-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103T00000X
CA86123106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty