Thriving Minds Therapy, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

THRIVING MINDS THERAPY, LLC

Practice address

102 E Cecil Ave Ste B
North East, MD 21901-4057

Phone

(667) 231-1269

NPI assigned

Mar 3, 2025

Last updated

Dec 19, 2025By 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. Tim Duane Gough Jr., LCSW-CNPI 1457085037

Title

Owner and Psychotherapist

Phone

(443) 760-0068

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Practitioners 1

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.

• Tim Duane Gough Jr., LCSW-C

  • Clinical Social Worker
  • North East, MD
  • NPI 1457085037
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1740960000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1766102400000",
    "number": "1679370159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 E CECIL AVE STE B",
            "city": "NORTH EAST",
            "state": "MD",
            "postal_code": "219014057",
            "telephone_number": "667-231-1269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 E CECIL AVE STE B",
            "city": "NORTH EAST",
            "state": "MD",
            "postal_code": "219014057",
            "telephone_number": "667-231-1269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THRIVING MINDS THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-03",
        "last_updated": "2025-12-19",
        "certification_date": "2025-12-19",
        "status": "A",
        "authorized_official_last_name": "GOUGH",
        "authorized_official_first_name": "TIM",
        "authorized_official_middle_name": "DUANE",
        "authorized_official_title_or_position": "OWNER AND PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "443-760-0068",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "LCSW-C"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Vilma Fondevilla Tadalan-Velasco, M.D.
• Christina L Taylor, LCPC
• Amy Theriault, CRNP
• Michelle Thompson, MPT
• Tri-State Health, Inc
• Tri-State Health, Inc
• Union Hospital of Cecil County, Inc. (Union Primary Care of North East)
• Unity Homecare Assisted Living
• Unity Homecare Assisted Living

• Clinical Social Worker in North East, MD
• Providers in North East, MD by specialty
• Clinical Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2025; 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.