Provider Demographics
NPI:1467967711
Name:THRIVE WELLNESS COUNSELING, LLC
Entity Type:Organization
Organization Name:THRIVE WELLNESS COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:COLLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS-TIMMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-531-7537
Mailing Address - Street 1:PO BOX 415
Mailing Address - Street 2:
Mailing Address - City:TABERNASH
Mailing Address - State:CO
Mailing Address - Zip Code:80478-0415
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:79050 US HWY 40
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:CO
Practice Address - Zip Code:80482
Practice Address - Country:US
Practice Address - Phone:970-531-7537
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-08
Last Update Date:2017-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACB7798101YA0400X
COLPC.0013935101YP2500X
CO251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty