NPIMap

Organization Active NPI

Thriving Minds Psychotherapy Services LLC

  • Clinical Social Worker
  • Norton Shores, MI
National Provider Identifier
1003635970
Registry record updated Oct 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
THRIVING MINDS PSYCHOTHERAPY SERVICES LLC
Practice address
3088 Sheffield St Ste a
Norton Shores, MI 49441-4290
Phone
(231) 737-1212
Fax
(231) 737-1218
NPI assigned
Oct 8, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Kelly M Dye, LCSW, LMSWNPI 1366192726
Title
Owner
Phone
(231) 855-0210

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X
Group Psychotherapy PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TP2701X
Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 104100000X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

3088 Sheffield St Ste a
Norton Shores, MI 49441-4290

Mailing address

465 S Bear Lake Rd
North Muskegon, MI 49445-2797
Phone (231) 855-0210

Other names 1

  • Thriving Minds Muskegon Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241209002568 MI Part B Supplier - Clinic/Group Practice 5698201077 Receives reassigned benefits from 5 practitioners
Practice locations: Norton Shores, MI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1728345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728864000000",
    "number": "1003635970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "465 S BEAR LAKE RD",
            "city": "NORTH MUSKEGON",
            "state": "MI",
            "postal_code": "494452797",
            "telephone_number": "231-855-0210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3088 SHEFFIELD ST STE A",
            "city": "NORTON SHORES",
            "state": "MI",
            "postal_code": "494414290",
            "telephone_number": "231-737-1212",
            "fax_number": "231-737-1218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THRIVING MINDS PSYCHOTHERAPY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-08",
        "last_updated": "2024-10-14",
        "certification_date": "2024-10-14",
        "status": "A",
        "authorized_official_last_name": "DYE",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "231-855-0210",
        "authorized_official_credential": "LCSW, LMSW"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Group Psychotherapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Thriving Minds Muskegon",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Norton Shores, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.