Provider Demographics
NPI:1235817628
Name:THRIVE ABA THERAPY LLC
Entity Type:Organization
Organization Name:THRIVE ABA THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KRISTEN
Authorized Official - Middle Name:
Authorized Official - Last Name:GAINER
Authorized Official - Suffix:
Authorized Official - Credentials:LBA, BCBA
Authorized Official - Phone:425-283-7360
Mailing Address - Street 1:17132 PARKSIDE WAY SE
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98058-9579
Mailing Address - Country:US
Mailing Address - Phone:425-283-7360
Mailing Address - Fax:
Practice Address - Street 1:17132 PARKSIDE WAY SE
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98058-9579
Practice Address - Country:US
Practice Address - Phone:425-283-7360
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-06
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1851078034OtherNPI