Provider Demographics
NPI:1952130502
Name:THRIVE CLINICAL PSYCHOLOGY
Entity type:Organization
Organization Name:THRIVE CLINICAL PSYCHOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:RIVIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LEWIN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:602-904-3126
Mailing Address - Street 1:10 SEWALL AVE STE 207
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446-5155
Mailing Address - Country:US
Mailing Address - Phone:602-904-3126
Mailing Address - Fax:
Practice Address - Street 1:10 SEWALL AVE STE 207
Practice Address - Street 2:
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02446-5155
Practice Address - Country:US
Practice Address - Phone:602-904-3126
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-31
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center