Provider Demographics
NPI:1619549052
Name:THRIVING SPARROW COUNSELING & WELLNESS, PLLC
Entity Type:Organization
Organization Name:THRIVING SPARROW COUNSELING & WELLNESS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:ROCHON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, RPT-S
Authorized Official - Phone:815-529-5933
Mailing Address - Street 1:256 STONEGATE RD
Mailing Address - Street 2:
Mailing Address - City:TROUT VALLEY
Mailing Address - State:IL
Mailing Address - Zip Code:60013-2524
Mailing Address - Country:US
Mailing Address - Phone:815-529-5933
Mailing Address - Fax:
Practice Address - Street 1:256 STONEGATE RD
Practice Address - Street 2:
Practice Address - City:TROUT VALLEY
Practice Address - State:IL
Practice Address - Zip Code:60013-2524
Practice Address - Country:US
Practice Address - Phone:815-529-5933
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-14
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL324781059001Medicaid