Neuro Thrive PC

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

NEURO THRIVE PC

Practice address

10472 Wellington Manor Ave
Las Vegas, NV 89129-4514

Phone

(301) 385-1784

NPI assigned

Jan 29, 2025

Organization subpart

No

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

Authorized official

Name

Evan FakhreddineNPI 1265933584

Title

Director

Phone

(301) 385-1784

Specialties & licenses 1

Addresses

Tax ID family

Neuro Thrive PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Neuro Thrive PC

  • Occupational Therapist
  • Las Vegas, NV
  • NPI 1013605880
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Evan Fakhreddine, OTR/L

  • Occupational Therapist
  • Las Vegas, NV
  • NPI 1265933584
  NPD Authorized official

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

{
    "created_epoch": "1738108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738108800000",
    "number": "1760295232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10472 WELLINGTON MANOR AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891294514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10472 WELLINGTON MANOR AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891294514",
            "telephone_number": "301-385-1784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEURO THRIVE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-29",
        "last_updated": "2025-01-29",
        "certification_date": "2025-01-29",
        "status": "A",
        "authorized_official_last_name": "FAKHREDDINE",
        "authorized_official_first_name": "EVAN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "301-385-1784"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Neuro Balance Therapy Las Vegas LLC
• Neuro Health LLC
• Neuro Rehab Inc
• Neuro Revolt Psychiatry PLLC
• Neuro Thrive PC
• Neurocommunication and Swallow LLC
• Neurological Associates of Nevada
• Neurology and Epilepsy Specialists PC
• Neurology Clinics of Nevada LLC
• Neuromonitoring Associates

• Behavior Analyst in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Behavior Analyst in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2025; 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.