Provider Demographics
NPI:1376350710
Name:THRIVE THERAPY SERVICES LLC
Entity type:Organization
Organization Name:THRIVE THERAPY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TIANA
Authorized Official - Middle Name:T
Authorized Official - Last Name:OCHOA TEO
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:401-692-4353
Mailing Address - Street 1:PO BOX 6867
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02940-6867
Mailing Address - Country:US
Mailing Address - Phone:401-692-4353
Mailing Address - Fax:
Practice Address - Street 1:390 BROADWAY UNIT 1
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02909-1468
Practice Address - Country:US
Practice Address - Phone:401-692-4353
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-17
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty