Organization Active NPI

Child Thrive, LLC

  • Clinical Child & Adolescent Psychologist
  • Merrillville, IN
National Provider Identifier
1306493465
Registry record updated Aug 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
Legal business name
CHILD THRIVE, LLC
Practice address
7863 Broadway Ste 239
Merrillville, IN 46410-5554
Phone
(219) 779-7339
NPI assigned
Aug 23, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2019

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

Authorized official

Name
Dr. Andrea Brandon, PSYD
Title
Owner
Phone
(219) 779-7339

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Child & Adolescent PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC2200X Primary

Addresses

Primary practice location

7863 Broadway Ste 239
Merrillville, IN 46410-5554

Mailing address

7863 Broadway Ste 239
Merrillville, IN 46410-5554
Phone (219) 779-7339

National Provider Directory

National Provider Directory

Locations

7863 Broadway
Ste 239
Merrillville, IN 46410
Phone (219) 779-7339

Practitioners & affiliated clinicians

Practitioners 1

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": "1566518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566518400000",
    "number": "1306493465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7863 BROADWAY STE 239",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464105554",
            "telephone_number": "219-779-7339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7863 BROADWAY STE 239",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464105554",
            "telephone_number": "219-779-7339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILD THRIVE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-23",
        "last_updated": "2019-08-23",
        "status": "A",
        "authorized_official_last_name": "BRANDON",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "219-779-7339",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Merrillville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.