Provider Demographics
NPI:1659004000
Name:THRIVE ART THERAPY, LLC
Entity Type:Organization
Organization Name:THRIVE ART THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, LEAD ART THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:RACHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ZUTTY
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC, ATR-BC
Authorized Official - Phone:872-870-1006
Mailing Address - Street 1:410 S MICHIGAN AVE STE 943
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60605-1399
Mailing Address - Country:US
Mailing Address - Phone:872-870-1006
Mailing Address - Fax:
Practice Address - Street 1:410 S MICHIGAN AVE STE 943
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60605-1399
Practice Address - Country:US
Practice Address - Phone:872-870-1006
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-05
Last Update Date:2022-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL180.010089OtherLCPC