| Thrive Behavioral Sciences Tampa Llc | |
|
5510 N Hesperides St Tampa FL 33614-5414 | |
| (813) 467-6111 | |
| (813) 467-6013 |
| Full Name | Thrive Behavioral Sciences Tampa Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 5510 N Hesperides St, Tampa, 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 Tampa Llc 5510 N Hesperides St Tampa FL 33614-5414 Ph: (813) 277-4571 | Thrive Behavioral Sciences Tampa Llc 5510 N Hesperides St Tampa FL 33614-5414 Ph: (813) 467-6111 |
| NPI Number | 1962989806 |
|---|---|
| Provider Enumeration Date | 07/24/2018 |
| Last Update Date | 09/04/2024 |
| Certification Date | 09/04/2024 |
| Medicare PECOS PAC ID | 2961747506 |
|---|---|
| Medicare Enrollment ID | O20181231000019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962989806 | NPI | - | NPPES |
| Provider Name | Michelle Robison |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1902107550 PECOS PAC ID: 1951590371 Enrollment ID: I20110114000771 |
| Provider Name | Deena D Ganesh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194100842 PECOS PAC ID: 3971819319 Enrollment ID: I20150901000273 |
| Provider Name | Misti Jo Foth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336687755 PECOS PAC ID: 6305190877 Enrollment ID: I20181120000415 |
| Provider Name | Ruchia Handy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588131312 PECOS PAC ID: 7911242656 Enrollment ID: I20181227000583 |
| Provider Name | Harley Dean Dorman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1336282722 PECOS PAC ID: 2466549456 Enrollment ID: I20200121001306 |
| Provider Name | Joselene Martinez |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1245577261 PECOS PAC ID: 7810317930 Enrollment ID: I20201012001114 |
| Provider Name | Dane J Youtz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659857555 PECOS PAC ID: 3072861079 Enrollment ID: I20211105001616 |
| Provider Name | Damaris Davila |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1932124310 PECOS PAC ID: 9638565401 Enrollment ID: I20220404000578 |
| Provider Name | Jessica Nicole Balok-angelilli |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013633635 PECOS PAC ID: 4486021532 Enrollment ID: I20221103000350 |
| 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 | Kimberly Mary Baldor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912699091 PECOS PAC ID: 2860853306 Enrollment ID: I20230801001892 |
| Provider Name | Denise Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770369860 PECOS PAC ID: 1658720941 Enrollment ID: I20231212002418 |
| Provider Name | Dawn Michelle Heckman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205600228 PECOS PAC ID: 6800246570 Enrollment ID: I20231220002985 |
| Provider Name | Ashley Elizabeth Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861869448 PECOS PAC ID: 2163874074 Enrollment ID: I20240116004091 |
| Provider Name | Karim Janice Torres Sanchez |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1063609683 PECOS PAC ID: 5395197891 Enrollment ID: I20240120000017 |
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