Provider Demographics
NPI:1669183042
Name:THRIVE CONSULTATION AND THERAPY
Entity type:Organization
Organization Name:THRIVE CONSULTATION AND THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:CHRISTOPHER
Authorized Official - Last Name:BOVINO
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA, LBA
Authorized Official - Phone:339-298-9495
Mailing Address - Street 1:40879 MEADOW VISTA PL
Mailing Address - Street 2:
Mailing Address - City:LOVETTSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20180-2267
Mailing Address - Country:US
Mailing Address - Phone:339-298-9495
Mailing Address - Fax:
Practice Address - Street 1:40879 MEADOW VISTA PL
Practice Address - Street 2:
Practice Address - City:LOVETTSVILLE
Practice Address - State:VA
Practice Address - Zip Code:20180-2267
Practice Address - Country:US
Practice Address - Phone:339-298-9495
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-07
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty