Provider Demographics
NPI:1568974244
Name:THRIVE COMMUNITY FAMILY THERAPY SERVICES INC
Entity Type:Organization
Organization Name:THRIVE COMMUNITY FAMILY THERAPY SERVICES INC
Other - Org Name:THRIVE THERAPEUTIC SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:L
Authorized Official - Last Name:STARKS
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:209-597-3587
Mailing Address - Street 1:2160 W GRANT LINE ROAD
Mailing Address - Street 2:SUITE 215
Mailing Address - City:TRACY
Mailing Address - State:CA
Mailing Address - Zip Code:95377
Mailing Address - Country:US
Mailing Address - Phone:209-597-3587
Mailing Address - Fax:209-255-4536
Practice Address - Street 1:2160 W GRANT LINE ROAD
Practice Address - Street 2:SUITE 215
Practice Address - City:TRACY
Practice Address - State:CA
Practice Address - Zip Code:95377
Practice Address - Country:US
Practice Address - Phone:209-597-3587
Practice Address - Fax:209-255-4536
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-02
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty