| Thrive Therapy, LLC | |
|
11990 Portland Ave Burnsville MN 55337-1516 | |
| (612) 568-6050 | |
| (952) 736-8375 |
| Full Name | Thrive Therapy, LLC |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 11990 Portland Ave, Burnsville, Minnesota |
| Authorized Official Name and Position | Ashlee Noel Secord (OWNER) |
| Authorized Official Contact | 6125686050 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Thrive Therapy, LLC 11990 Portland Ave Burnsville MN 55337-1516 Ph: (612) 568-6050 | Thrive Therapy, LLC 11990 Portland Ave Burnsville MN 55337-1516 Ph: (612) 568-6050 |
| NPI Number | 1073902177 |
|---|---|
| Provider Enumeration Date | 01/13/2015 |
| Last Update Date | 07/15/2022 |
| Certification Date | 07/15/2022 |
| Medicare PECOS PAC ID | 1355719287 |
|---|---|
| Medicare Enrollment ID | O20221123002081 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073902177 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | () | Secondary |
| 106H00000X | Marriage & Family Therapist | 1971 (Minnesota) | Secondary |
| 106H00000X | Marriage & Family Therapist | () | Primary |
| Provider Name | Ajda Kay Lommen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760724751 PECOS PAC ID: 5294970976 Enrollment ID: I20130329000059 |
| Provider Name | Dawn M Ebeling |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063051639 PECOS PAC ID: 3072949007 Enrollment ID: I20200211001437 |
| Provider Name | Uhunoma L Osadolor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295314391 PECOS PAC ID: 3173925823 Enrollment ID: I20210716002533 |
| Provider Name | Rosilynn Nicole Morris |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487431177 PECOS PAC ID: 2062866619 Enrollment ID: I20230929002825 |
| Provider Name | Gretchen Phung |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1992248231 PECOS PAC ID: 8527402585 Enrollment ID: I20240216004213 |
| Provider Name | Matthew Lee Sutera |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1265897011 PECOS PAC ID: 2860838422 Enrollment ID: I20240306001973 |
| Provider Name | Ashlee Noel Secord |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1659516888 PECOS PAC ID: 4082082912 Enrollment ID: I20240306002525 |
| Provider Name | Reece Forrester |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1073799102 PECOS PAC ID: 8729452842 Enrollment ID: I20240313001512 |
| Provider Name | Michaela Farley |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1396318903 PECOS PAC ID: 4789021684 Enrollment ID: I20240327003396 |
| Provider Name | Lexie Marie Mccarthy |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578240255 PECOS PAC ID: 9032557418 Enrollment ID: I20240404000535 |
| Provider Name | Cindy Lou Fischer-hancock |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1396813671 PECOS PAC ID: 7012355373 Enrollment ID: I20240404004021 |
| Provider Name | Amy Meyer |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1356931745 PECOS PAC ID: 4981042082 Enrollment ID: I20240409003078 |
| Provider Name | Angela Emily Brodine |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1265075162 PECOS PAC ID: 8921446931 Enrollment ID: I20240409003646 |
| Provider Name | Sylke M Knopp |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1528338845 PECOS PAC ID: 0143660548 Enrollment ID: I20240502001435 |
| Provider Name | Andrew Steven Kaehr |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1992098453 PECOS PAC ID: 8628418928 Enrollment ID: I20240503001596 |
| Provider Name | Patricia Lea Beaudoin |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1013621770 PECOS PAC ID: 7012455959 Enrollment ID: I20240809003413 |
| Provider Name | Breanna Reed |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1659016541 PECOS PAC ID: 8729527833 Enrollment ID: I20240903001403 |
| Provider Name | Christina Marie Irrgang-wade |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1134690969 PECOS PAC ID: 1153861083 Enrollment ID: I20240906001192 |
| Provider Name | Rebecca Jean Hines |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1326583626 PECOS PAC ID: 1052844461 Enrollment ID: I20241023004349 |
| Provider Name | Ashley Hauffe |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1669803474 PECOS PAC ID: 6507399946 Enrollment ID: I20241024000716 |
| Provider Name | Ashley Toussaint |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1750961009 PECOS PAC ID: 3375071384 Enrollment ID: I20250103001565 |
| Provider Name | Lauren Noel |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1154058063 PECOS PAC ID: 5890204259 Enrollment ID: I20250605001715 |
| Provider Name | Samuel Secord |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1093324022 PECOS PAC ID: 4688188238 Enrollment ID: I20250708000366 |
| Provider Name | Kelly Harding |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033912563 PECOS PAC ID: 6305350315 Enrollment ID: I20250710000852 |
| Provider Name | Amy Jeanette Krueger |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1841686896 PECOS PAC ID: 7618450099 Enrollment ID: I20260313001514 |
Thrive Therapy, LLC Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 11990 Portland Ave, Burnsville, MN 55337 Phone: 612-568-6050 Fax: 952-479-7896 |
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