| Thrive Therapeutic Services, Llc | |
|
200 E Evergreen Ave Ste 106 Mount Prospect IL 60056-3240 | |
| (847) 749-3807 | |
| Not Available |
| Full Name | Thrive Therapeutic Services, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 200 E Evergreen Ave Ste 106, Mount Prospect, Illinois |
| Authorized Official Name and Position | Kathleen Erin Eccles (OWNER) |
| Authorized Official Contact | 8477493807 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Thrive Therapeutic Services, Llc 200 E Evergreen Ave Ste 106 Mount Prospect IL 60056-3240 Ph: () - | Thrive Therapeutic Services, Llc 200 E Evergreen Ave Ste 106 Mount Prospect IL 60056-3240 Ph: (847) 749-3807 |
| NPI Number | 1568694578 |
|---|---|
| Provider Enumeration Date | 08/10/2009 |
| Last Update Date | 12/07/2023 |
| Certification Date | 12/07/2023 |
| Medicare PECOS PAC ID | 8527206069 |
|---|---|
| Medicare Enrollment ID | O20231026003863 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568694578 | NPI | - | NPPES |
| 1104058114 | Other | OWNER NPI | |
| 12026361 | Other | CAQH | |
| 325645863001 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP1600X | Counselor - Pastoral | 178004019 (Illinois) | Secondary |
| 1041C0700X | Social Worker - Clinical | 149013183 (Illinois) | Primary |
| Provider Name | Kathleen E Eccles |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104058114 PECOS PAC ID: 3577701028 Enrollment ID: I20130523000224 |
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