Provider Demographics
NPI:1891356366
Name:THRIVE INTEGRATIVE COUNSELING SERVICES LLC
Entity Type:Organization
Organization Name:THRIVE INTEGRATIVE COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KARI
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:CRAWFORD
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:870-897-9508
Mailing Address - Street 1:262 SOUTHWEST DR
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72401-5829
Mailing Address - Country:US
Mailing Address - Phone:870-203-6100
Mailing Address - Fax:800-421-5290
Practice Address - Street 1:262 SOUTHWEST DR
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401-5829
Practice Address - Country:US
Practice Address - Phone:870-203-6100
Practice Address - Fax:800-421-5290
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-25
Last Update Date:2020-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR238775744Medicaid