| Thrive Behavioral Health of Michigan | |
|
47100 Schoenherr Rd Ste C Shelby Township MI 48315-4714 | |
| (586) 744-9026 | |
| Not Available |
| Full Name | Thrive Behavioral Health of Michigan |
|---|---|
| Speciality | Psychologist |
| Location | 47100 Schoenherr Rd Ste C, Shelby Township, Michigan |
| Authorized Official Name and Position | Amy Hanes (CEO) |
| Authorized Official Contact | 5867449026 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Thrive Behavioral Health of Michigan 47100 Schoenherr Rd Ste C Shelby Township MI 48315-4714 Ph: (586) 744-9026 | Thrive Behavioral Health of Michigan 47100 Schoenherr Rd Ste C Shelby Township MI 48315-4714 Ph: (586) 744-9026 |
| NPI Number | 1245667443 |
|---|---|
| Provider Enumeration Date | 10/02/2013 |
| Last Update Date | 12/04/2024 |
| Certification Date | 12/03/2024 |
| Medicare PECOS PAC ID | 2264664630 |
|---|---|
| Medicare Enrollment ID | O20140417001020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245667443 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 6301014205 (Michigan) | Primary |
| Provider Name | Victoria Evangelista |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1326439399 PECOS PAC ID: 4486093788 Enrollment ID: I20240419000881 |
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