Provider Demographics
NPI:1659725935
Name:THRIVE MENTAL HEALTH SERVICES
Entity Type:Organization
Organization Name:THRIVE MENTAL HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERIKA
Authorized Official - Middle Name:BRAUN
Authorized Official - Last Name:COPPEN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC-MHSP
Authorized Official - Phone:615-499-8636
Mailing Address - Street 1:1143 COLUMBIA AVE STE C20-C
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37064-3631
Mailing Address - Country:US
Mailing Address - Phone:615-499-8636
Mailing Address - Fax:615-261-8898
Practice Address - Street 1:1143 COLUMBIA AVE STE C20-C
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37064-3631
Practice Address - Country:US
Practice Address - Phone:615-499-8636
Practice Address - Fax:615-261-8898
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-22
Last Update Date:2016-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2253101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1710274758OtherNPI - INDIVIDUAL