Provider Demographics
NPI:1619402062
Name:THRIVING INSPIRED, LLC
Entity Type:Organization
Organization Name:THRIVING INSPIRED, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LORNA
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:770-339-7667
Mailing Address - Street 1:PO BOX 624
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-0624
Mailing Address - Country:US
Mailing Address - Phone:678-396-8855
Mailing Address - Fax:678-404-4444
Practice Address - Street 1:265 W PIKE ST
Practice Address - Street 2:STE 4
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30046-4896
Practice Address - Country:US
Practice Address - Phone:678-396-8855
Practice Address - Fax:678-407-4444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-24
Last Update Date:2017-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC007094101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty