Provider Demographics
NPI:1043778046
Name:THRIVE COUNSELING AND EVALUATION
Entity Type:Organization
Organization Name:THRIVE COUNSELING AND EVALUATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:VANESSA
Authorized Official - Middle Name:
Authorized Official - Last Name:DYKSTRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-271-6582
Mailing Address - Street 1:3701 W 49TH ST STE 206
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57106-4219
Mailing Address - Country:US
Mailing Address - Phone:605-271-6582
Mailing Address - Fax:605-271-6590
Practice Address - Street 1:3701 W 49TH ST STE 206
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57106-4219
Practice Address - Country:US
Practice Address - Phone:605-271-6582
Practice Address - Fax:605-271-6590
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-08
Last Update Date:2019-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty