Provider Demographics
NPI:1013551803
Name:ASHLEE SECORD MA LMFT
Entity Type:Organization
Organization Name:ASHLEE SECORD MA LMFT
Other - Org Name:THRIVE THERAPY, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEE
Authorized Official - Middle Name:NOEL
Authorized Official - Last Name:SECORD
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:612-568-6050
Mailing Address - Street 1:11990 PORTLAND AVE
Mailing Address - Street 2:
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55337-1516
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11990 PORTLAND AVE
Practice Address - Street 2:
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55337-1516
Practice Address - Country:US
Practice Address - Phone:612-568-6050
Practice Address - Fax:952-479-7896
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ASHLEE SECORD, MA, LMFT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-11-05
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health