| Thrive Behavioral Sciences Orlando Llc | |
|
4700 Millenia Blvd Ste 500 Orlando FL 32839-6019 | |
| (813) 467-6111 | |
| Not Available |
| Full Name | Thrive Behavioral Sciences Orlando Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 4700 Millenia Blvd Ste 500, Orlando, Florida |
| Authorized Official Name and Position | Jolene De La Gardelle (VP OPERATIONS) |
| Authorized Official Contact | 8132774571 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Thrive Behavioral Sciences Orlando Llc 5510 N Hesperides St Tampa FL 33614-5414 Ph: (813) 277-4571 | Thrive Behavioral Sciences Orlando Llc 4700 Millenia Blvd Ste 500 Orlando FL 32839-6019 Ph: (813) 467-6111 |
| NPI Number | 1063979730 |
|---|---|
| Provider Enumeration Date | 02/28/2019 |
| Last Update Date | 08/16/2024 |
| Certification Date | 08/16/2024 |
| Medicare PECOS PAC ID | 9739420654 |
|---|---|
| Medicare Enrollment ID | O20190402002627 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063979730 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0805X | Psychiatry & Neurology - Geriatric Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Shatha Atiya |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1487814729 PECOS PAC ID: 8426107202 Enrollment ID: I20090527000596 |
| Provider Name | Chrystel D Hart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912256322 PECOS PAC ID: 0749432342 Enrollment ID: I20121205000464 |
| Provider Name | Meredith M Brainard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912455981 PECOS PAC ID: 0840578597 Enrollment ID: I20161031002047 |
| Provider Name | Kristopher Stewart Oldham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619357787 PECOS PAC ID: 7315250248 Enrollment ID: I20161119000257 |
| Provider Name | Toni D Sanchez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588195754 PECOS PAC ID: 3476830332 Enrollment ID: I20170502000002 |
| Provider Name | Ruchia Handy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588131312 PECOS PAC ID: 7911242656 Enrollment ID: I20181227000583 |
| Provider Name | Yvonka S Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548681190 PECOS PAC ID: 1658605084 Enrollment ID: I20190619000058 |
| Provider Name | Louella C Marinos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689230591 PECOS PAC ID: 7618202565 Enrollment ID: I20190715001347 |
| Provider Name | Amy L Fiessinger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578751533 PECOS PAC ID: 1355594672 Enrollment ID: I20200128001097 |
| Provider Name | Michelle M Cordero Soto |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1689007734 PECOS PAC ID: 9931539814 Enrollment ID: I20200416001026 |
| Provider Name | Joselene Martinez |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1245577261 PECOS PAC ID: 7810317930 Enrollment ID: I20201012001114 |
| Provider Name | Valerie M Acosta |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1255773586 PECOS PAC ID: 5991112062 Enrollment ID: I20210408000523 |
| Provider Name | Tamara Velazquez |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1053521062 PECOS PAC ID: 3870992399 Enrollment ID: I20210602002866 |
| Provider Name | Bahattin Ergin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386312023 PECOS PAC ID: 9335546258 Enrollment ID: I20210920003347 |
| Provider Name | Deonne L Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770172512 PECOS PAC ID: 0042617490 Enrollment ID: I20210928000524 |
| Provider Name | Kimberly A Whitchard |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1104192954 PECOS PAC ID: 2264692375 Enrollment ID: I20211005003708 |
| Provider Name | Anquanette Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881360493 PECOS PAC ID: 6507256070 Enrollment ID: I20211124001764 |
| Provider Name | Mayra Liz Lugo-gonzalez |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1255610531 PECOS PAC ID: 3577956416 Enrollment ID: I20220217000017 |
| Provider Name | Jeanne P Girodier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891303186 PECOS PAC ID: 6507240009 Enrollment ID: I20220901001770 |
| Provider Name | Rachel Nichole Clarke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003550328 PECOS PAC ID: 7416322565 Enrollment ID: I20230404000433 |
| Provider Name | Jennifer St Louis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992582456 PECOS PAC ID: 5496104507 Enrollment ID: I20231214003326 |
| Provider Name | Ashley Elizabeth Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861869448 PECOS PAC ID: 2163874074 Enrollment ID: I20240116004091 |
| Provider Name | Janet Heyden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669845731 PECOS PAC ID: 1254863509 Enrollment ID: I20241011002568 |
| Provider Name | Ana Teresa Alcala-calderon |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1619517364 PECOS PAC ID: 2961935853 Enrollment ID: I20241030004283 |
| Provider Name | Jeanne Chatie Percy-rivera |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255809125 PECOS PAC ID: 0345581070 Enrollment ID: I20241125003341 |
| Provider Name | Melissa Dole |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1437502051 PECOS PAC ID: 6608302674 Enrollment ID: I20241213002018 |
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