Provider Demographics
NPI:1356174882
Name:NURTURE AND THRIVE PSYCHOTHERAPY PLLC
Entity type:Organization
Organization Name:NURTURE AND THRIVE PSYCHOTHERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:BRIGID
Authorized Official - Middle Name:M
Authorized Official - Last Name:DAGENFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:614-580-7349
Mailing Address - Street 1:5615 W GIDDINGS ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60630-3213
Mailing Address - Country:US
Mailing Address - Phone:614-580-7349
Mailing Address - Fax:
Practice Address - Street 1:5419 W LAWRENCE AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60630-3686
Practice Address - Country:US
Practice Address - Phone:312-869-9899
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-21
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty