Neurothrive, LLC

Primary specialty

PsychologistTaxonomy code 103T00000X

License

04502 Issued in MD

Legal business name

NEUROTHRIVE, LLC

Practice address

1205 York Rd Ste 11
Lutherville, MD 21093-6211

Phone

(443) 810-9483

NPI assigned

May 15, 2015

Last updated

Apr 25, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Mark TrullingerNPI 1902100274

Title

Owner

Phone

(443) 810-9483

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Henry E Pigott, PH.D.

  • Clinical Psychologist
  • Juno Beach, FL
  • NPI 1619312204

  MD

  Medicare reassignment NPD
• Mark Stephen Trullinger

  • Clinical Psychologist
  • Lutherville, MD
  • NPI 1902100274
  NPD Authorized official
• Deepti Pradhan

  • Clinical Psychologist
  • Lutherville, MD
  • NPI 1437506334
  NPD (past)

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

{
    "created_epoch": "1431648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461542400000",
    "number": "1063890556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13941 ALDERTON RD",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209062063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 YORK RD STE 11",
            "city": "LUTHERVILLE",
            "state": "MD",
            "postal_code": "210936211",
            "telephone_number": "443-810-9483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROTHRIVE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-15",
        "last_updated": "2016-04-25",
        "status": "A",
        "authorized_official_last_name": "TRULLINGER",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "443-810-9483",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MD",
            "license": "04502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Sally A. Neustadt, LCSW-C
• Mary Newman, M.D.
• Supak Anne Ngamsnga, M.S., OTR/L
• Thy Bich Nguyen, MD
• Sofilia Ngwafang

• Psychologist in Lutherville, MD
• Providers in Lutherville, MD by specialty
• Psychologist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2016; 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.