Provider Demographics
NPI:1073050290
Name:THRIVE TRAUMA, INC.
Entity Type:Organization
Organization Name:THRIVE TRAUMA, INC.
Other - Org Name:THRIVE COUNSELING AND TRAUMA THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEFFERY
Authorized Official - Middle Name:
Authorized Official - Last Name:HARROLLE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:205-607-7603
Mailing Address - Street 1:1034 23RD ST S
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35205-2481
Mailing Address - Country:US
Mailing Address - Phone:205-470-3934
Mailing Address - Fax:205-978-0072
Practice Address - Street 1:1034 23RD ST S
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35205-2481
Practice Address - Country:US
Practice Address - Phone:205-705-0195
Practice Address - Fax:205-978-0072
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-25
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty