Organization
THRIVING POTENTIAL, PLLC
Active
Organization
THRIVING POTENTIAL, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMANTHA WILSON LPC (CLINICIAN)
(860) 941-7550
Entity
Organization
Contact information
Practice address
2 CHAPMAN LN UNIT 11, GALES FERRY, CT 06335-1222
(860) 941-7550
Mailing address
22 HOMESTEAD RD APT D, LEDYARD, CT 06339-1402
(860) 941-7550
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
10/17/2019
Last updated
10/17/2019
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