Provider Demographics
NPI:1659996692
Name:THRIVE PSYCHOLOGY CENTER, LLC
Entity Type:Organization
Organization Name:THRIVE PSYCHOLOGY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ATKIN
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:908-227-0424
Mailing Address - Street 1:35 LEWIN AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-4674
Mailing Address - Country:US
Mailing Address - Phone:908-227-0424
Mailing Address - Fax:
Practice Address - Street 1:699 CROSS ST STE 110
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-4681
Practice Address - Country:US
Practice Address - Phone:908-227-0424
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-16
Last Update Date:2020-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty