Provider Demographics
NPI:1548860968
Name:THRIVING LIFESTYLES COUNSELING SOLUTIONS, LLC
Entity type:Organization
Organization Name:THRIVING LIFESTYLES COUNSELING SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:NUNEZ
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:309-431-1555
Mailing Address - Street 1:629 11TH ST
Mailing Address - Street 2:
Mailing Address - City:SILVIS
Mailing Address - State:IL
Mailing Address - Zip Code:61282-1553
Mailing Address - Country:US
Mailing Address - Phone:309-431-1555
Mailing Address - Fax:855-515-0810
Practice Address - Street 1:223 1 STREET
Practice Address - Street 2:
Practice Address - City:COLONA
Practice Address - State:IL
Practice Address - Zip Code:61241
Practice Address - Country:US
Practice Address - Phone:309-431-1555
Practice Address - Fax:855-515-0810
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-26
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty