Organization Active NPI

Live to Thrive

  • Mental Health Counselor
  • Suffern, NY
National Provider Identifier
1386122604
Registry record updated Jul 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
NY007529 Issued in NY
Legal business name
LIVE TO THRIVE
Practice address
4 Executive Blvd Ste 204
Suffern, NY 10901-8202
Phone
(646) 267-1346
NPI assigned
Jul 30, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2018

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

Authorized official

Name
Ms. Amelie Southwood, LMHCNPI 1932642014
Title
Ceo
Phone
(646) 267-1346

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X NY007529 NY Primary

Addresses

Primary practice location

4 Executive Blvd Ste 204
Suffern, NY 10901-8202

Mailing address

16 Haven CT
Nyack, NY 10960-1933
Phone (646) 267-1346

National Provider Directory

National Provider Directory

Locations

4 Executive Blvd
Ste 204
Suffern, NY 10901
Phone (845) 304-5082

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": "1532908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1532908800000",
    "number": "1386122604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 HAVEN CT",
            "city": "NYACK",
            "state": "NY",
            "postal_code": "109601933",
            "telephone_number": "646-267-1346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 EXECUTIVE BLVD STE 204",
            "city": "SUFFERN",
            "state": "NY",
            "postal_code": "109018202",
            "telephone_number": "646-267-1346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVE TO THRIVE",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-30",
        "last_updated": "2018-07-30",
        "status": "A",
        "authorized_official_last_name": "SOUTHWOOD",
        "authorized_official_first_name": "AMELIE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "646-267-1346",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "NY007529",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Suffern, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2018; 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.