Provider Demographics
NPI:1376129817
Name:THRIVE COUNSELING AND MEDIATION
Entity Type:Organization
Organization Name:THRIVE COUNSELING AND MEDIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JEWLINA
Authorized Official - Middle Name:
Authorized Official - Last Name:COLEMAN-KING
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:832-851-7373
Mailing Address - Street 1:1502 PARTNERSHIP WAY APT 5205
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77449-5962
Mailing Address - Country:US
Mailing Address - Phone:832-851-7373
Mailing Address - Fax:
Practice Address - Street 1:2211 NORFOLK ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77098-4096
Practice Address - Country:US
Practice Address - Phone:832-851-7373
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-23
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty