Provider Demographics
NPI:1629775937
Name:THRIVE: COUNSELING AND PSYCHOLOGICAL SERVICES
Entity type:Organization
Organization Name:THRIVE: COUNSELING AND PSYCHOLOGICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:L
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:202-810-4518
Mailing Address - Street 1:555 MASSACHUSETTS AVE NW APT 808
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20001-4721
Mailing Address - Country:US
Mailing Address - Phone:202-486-8868
Mailing Address - Fax:
Practice Address - Street 1:1200 G ST NW STE 800
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20005-6705
Practice Address - Country:US
Practice Address - Phone:202-810-4518
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-08
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty