Provider Demographics
NPI:1568113926
Name:THRIVE COUNSELING SERVICES, PLLC
Entity Type:Organization
Organization Name:THRIVE COUNSELING SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:SMILEDGE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:208-518-6400
Mailing Address - Street 1:3825 N RAMSEY RD APT 108
Mailing Address - Street 2:
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83815-1616
Mailing Address - Country:US
Mailing Address - Phone:208-518-6400
Mailing Address - Fax:
Practice Address - Street 1:8596 N WAYNE DR STE A6
Practice Address - Street 2:
Practice Address - City:HAYDEN
Practice Address - State:ID
Practice Address - Zip Code:83835-5068
Practice Address - Country:US
Practice Address - Phone:208-518-6400
Practice Address - Fax:208-216-7762
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-17
Last Update Date:2022-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty