Provider Demographics
NPI:1245667443
Name:THRIVE BEHAVIORAL HEALTH
Entity type:Organization
Organization Name:THRIVE BEHAVIORAL HEALTH
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:HANES
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:586-744-9026
Mailing Address - Street 1:47100 SCHOENHERR RD STE C
Mailing Address - Street 2:
Mailing Address - City:SHELBY TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48315-4714
Mailing Address - Country:US
Mailing Address - Phone:586-744-9026
Mailing Address - Fax:
Practice Address - Street 1:47100 SCHOENHERR RD STE C
Practice Address - Street 2:
Practice Address - City:SHELBY TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48315-4714
Practice Address - Country:US
Practice Address - Phone:586-744-9026
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THRIVE BEHAVIORAL HEALTH OF MICHIGAN
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-10-02
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301014205103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty