| Thrive Behavioral Health, LLC | |
|
12510 Prosperity Dr Ste 200 Silver Spring MD 20904-1640 | |
| (410) 780-5203 | |
| (410) 780-5205 |
| Full Name | Thrive Behavioral Health, LLC |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 12510 Prosperity Dr Ste 200, Silver Spring, Maryland |
| Authorized Official Name and Position | Elizabeth a Hymel (CEO) |
| Authorized Official Contact | 4107805203 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Thrive Behavioral Health, LLC 9627 Philadelphia Rd Ste 160 Rosedale MD 21237-4157 Ph: (410) 780-5203 | Thrive Behavioral Health, LLC 12510 Prosperity Dr Ste 200 Silver Spring MD 20904-1640 Ph: (410) 780-5203 |
| NPI Number | 1306396163 |
|---|---|
| Provider Enumeration Date | 10/05/2016 |
| Last Update Date | 05/20/2024 |
| Certification Date | 05/20/2024 |
| Medicare PECOS PAC ID | 3476777947 |
|---|---|
| Medicare Enrollment ID | O20190603000325 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306396163 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (Maryland) | Primary |
| Provider Name | Ganiyat a Adeyemo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588113351 PECOS PAC ID: 7719269745 Enrollment ID: I20170126001181 |
| Provider Name | Jennifer Bambach |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629502786 PECOS PAC ID: 8527326024 Enrollment ID: I20220308001364 |
| Provider Name | Carolyn Howell |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1932368735 PECOS PAC ID: 5799953931 Enrollment ID: I20220331002049 |
| Provider Name | Tanya Gooding |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922797554 PECOS PAC ID: 8729439427 Enrollment ID: I20240107000146 |
| Provider Name | Kelly Jeanne Dominic |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1427507557 PECOS PAC ID: 9335570118 Enrollment ID: I20260217001434 |
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