| Thrive Mental Wellness, Pllc | |
|
13508 Julie Dr Poplar Grove IL 61065-7829 | |
| (815) 596-0098 | |
| Not Available |
| Full Name | Thrive Mental Wellness, Pllc |
|---|---|
| Speciality | Nurse Practitioner - Psychiatric/mental Health |
| Location | 13508 Julie Dr, Poplar Grove, Illinois |
| Authorized Official Name and Position | Courtney Nicolle Forman (OWNER) |
| Authorized Official Contact | 8152098486 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Thrive Mental Wellness, Pllc 13508 Julie Dr Poplar Grove IL 61065-7829 Ph: (815) 596-0098 | Thrive Mental Wellness, Pllc 13508 Julie Dr Poplar Grove IL 61065-7829 Ph: (815) 596-0098 |
| NPI Number | 1447047469 |
|---|---|
| Provider Enumeration Date | 04/23/2025 |
| Last Update Date | 04/27/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447047469 | NPI | - | NPPES |
| 1376099127 | Other | IL | OTHER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | (* (Not Available)) | Primary |
Riverside Dental Investments Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 13510 Julie Dr, Poplar Grove, IL 61065 Phone: 815-765-9900 Fax: 815-765-9901 |