Thriveworks Clinical - Indiana LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

THRIVEWORKS CLINICAL - INDIANA LLC

Practice address

250 Main St Ste 420
Lafayette, IN 47901-1285

Phone

(855) 284-7483

NPI assigned

Jan 23, 2023

Organization subpart

No

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

Authorized official

Name

Anthony Centore, CEO

Title

Ceo

Phone

(540) 217-6461

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1674432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674432000000",
    "number": "1497460547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 748465",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303748465",
            "telephone_number": "855-284-7483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 MAIN ST STE 420",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479011285",
            "telephone_number": "855-284-7483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THRIVEWORKS CLINICAL - INDIANA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-23",
        "last_updated": "2023-01-23",
        "certification_date": "2023-01-23",
        "status": "A",
        "authorized_official_last_name": "CENTORE",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "540-217-6461",
        "authorized_official_credential": "CEO"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Kay Thompson
• Taylor Nicole Thompson
• Taylor Nicole Thompson, BCBA, LBA, MS
• Julia A Thorington, NP
• Patricia M Thorn Kish, LCSW
• Lydia Marie Ticen, RBT
• Kristie Tidrick, RN
• Rock Gerard Tiffault, M.D.
• Andrea Leann Tiffin, APRN
• Madison Tilley

• Mental Health Counselor in Lafayette, IN
• Providers in Lafayette, IN by specialty
• Mental Health Counselor in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2023; 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.