| 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 | () | Primary |
| Provider Name | Shatha Atiya |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1487814729 PECOS PAC ID: 8426107202 Enrollment ID: I20090527000596 |
| Provider Name | Erik N Libby |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790881688 PECOS PAC ID: 3173717048 Enrollment ID: I20101104000759 |
| Provider Name | Michelle Robison |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1902107550 PECOS PAC ID: 1951590371 Enrollment ID: I20110114000771 |
| Provider Name | Chrystel D Hart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912256322 PECOS PAC ID: 0749432342 Enrollment ID: I20121205000464 |
| Provider Name | Patricia Adriana Ares-romero |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1902823719 PECOS PAC ID: 0648256362 Enrollment ID: I20130322000300 |
| Provider Name | Emily Avgeropoulos |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1619370103 PECOS PAC ID: 7810214806 Enrollment ID: I20150401001394 |
| 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 | Ryan W Macalua |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174919377 PECOS PAC ID: 4880975911 Enrollment ID: I20170104001801 |
| Provider Name | Toni D Sanchez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588195754 PECOS PAC ID: 3476830332 Enrollment ID: I20170502000002 |
| Provider Name | Steven a Sylvia |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487027405 PECOS PAC ID: 4688943756 Enrollment ID: I20170705001433 |
| 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 | Jesselin Diamond Tinsley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447922745 PECOS PAC ID: 6103216270 Enrollment ID: I20211203000769 |
| 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 | Elizabeth Tita |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467165134 PECOS PAC ID: 7012380215 Enrollment ID: I20230309001849 |
| Provider Name | Georgiann Ostrander |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881319440 PECOS PAC ID: 3274907423 Enrollment ID: I20230330000031 |
| Provider Name | Rachel Nichole Clarke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003550328 PECOS PAC ID: 7416322565 Enrollment ID: I20230404000433 |
| Provider Name | Fred Moline |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649971334 PECOS PAC ID: 1658736319 Enrollment ID: I20230502001434 |
| Provider Name | Kristine Renee Shuryan |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1376248906 PECOS PAC ID: 3173981347 Enrollment ID: I20230620002476 |
| Provider Name | Breona Lashay Alvarado |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1679261242 PECOS PAC ID: 3870954522 Enrollment ID: I20230728000267 |
| 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 Henry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861869448 PECOS PAC ID: 2163874074 Enrollment ID: I20240116004091 |
| Provider Name | D'arthana Lorenzo Burrell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578874095 PECOS PAC ID: 9234676875 Enrollment ID: I20240801000178 |
| Provider Name | Kailey Jo Mckenna |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396505434 PECOS PAC ID: 9931647310 Enrollment ID: I20240816000168 |
| Provider Name | Bertine Luzincourt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386485118 PECOS PAC ID: 4385185750 Enrollment ID: I20240925002698 |
| Provider Name | Luz Reina Ledesma |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689428526 PECOS PAC ID: 0143751628 Enrollment ID: I20241008003202 |
| 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 |
| Provider Name | Rubin Joseph |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013796648 PECOS PAC ID: 0749717957 Enrollment ID: I20241230003478 |
| Provider Name | Natalia Urquiza-manzano |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1316457070 PECOS PAC ID: 7719401447 Enrollment ID: I20250403002285 |
| Provider Name | Mamatha Cheong |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205647666 PECOS PAC ID: 8729506779 Enrollment ID: I20250514001517 |
| Provider Name | Stephanie Thadal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235989393 PECOS PAC ID: 6709316961 Enrollment ID: I20250710001799 |
| Provider Name | Nadine Fiege |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467341495 PECOS PAC ID: 9133621790 Enrollment ID: I20250904001624 |
| Provider Name | Jessica Calabro |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1427795145 PECOS PAC ID: 1951807973 Enrollment ID: I20250930001232 |
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