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Organization
THRIVE THERAPEUTIC SERVICES, LLC
Active
Organization
THRIVE THERAPEUTIC SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHLEEN ERIN ECCLES (OWNER)
(847) 749-3807
Entity
Organization
Contact information
Practice address
200 E EVERGREEN AVE STE 106, MOUNT PROSPECT, IL 60056-3240
(847) 749-3807
Mailing address
200 E EVERGREEN AVE STE 106, MOUNT PROSPECT, IL 60056-3240
Taxonomy
Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
178004019
IL
1041C0700X
Clinical Social Worker
Primary
149013183
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1104058114
OWNER NPI
—
01
—
12026361
CAQH
—
05
—
325645863001
—
IL
Enumeration date
08/10/2009
Last updated
12/07/2023
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