Organization
DSTW, LLC
Active
Parent organization
REVIVE & THRIVE COUNSELING ASSOCIATES
Other names
Revive & Thrive Counseling Associates
Organization subpart
Yes
Provider details
NPI number
Legal business name
REVIVE & THRIVE COUNSELING ASSOCIATES
Authorized official
MRS. MICHELLE DVORAK MS, LAMFT, CSAC (OWNER PROVIDER)
(715) 574-7419
Entity
Organization
Contact information
Practice address
1001 PROGRESSIVE AVE, M122, MEDFORD, WI 54451-1781
(715) 574-7419
Mailing address
PO BOX 2, MEDFORD, WI 54451-0002
(715) 574-7419
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100140533
—
WI
05
—
10090770
—
WI
Enumeration date
05/04/2026
Last updated
05/05/2026
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