Provider Demographics
NPI:1801601091
Name:DESERT THRIVING LLC
Entity type:Organization
Organization Name:DESERT THRIVING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:ALBONICO
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:415-246-8530
Mailing Address - Street 1:36 SIERRA BLANCA
Mailing Address - Street 2:
Mailing Address - City:CEDAR CREST
Mailing Address - State:NM
Mailing Address - Zip Code:87008-9445
Mailing Address - Country:US
Mailing Address - Phone:415-246-8530
Mailing Address - Fax:
Practice Address - Street 1:36 SIERRA BLANCA
Practice Address - Street 2:
Practice Address - City:CEDAR CREST
Practice Address - State:NM
Practice Address - Zip Code:87008-9445
Practice Address - Country:US
Practice Address - Phone:415-246-8530
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-12
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty