| Thriveworks | |
|
700 Churchill Ct Ste 110 Woodstock GA 30188-6880 | |
| (770) 284-9092 | |
| Not Available |
| Full Name | Thriveworks |
|---|---|
| Speciality | Psychologist |
| Location | 700 Churchill Ct Ste 110, Woodstock, Georgia |
| Authorized Official Name and Position | A A Esfahani (PRESIDENT/MEDICAL DIRECTOR) |
| Authorized Official Contact | 6173790496 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Thriveworks 700 Churchill Ct Ste 110 Woodstock GA 30188-6880 Ph: (617) 379-0496 | Thriveworks 700 Churchill Ct Ste 110 Woodstock GA 30188-6880 Ph: (770) 284-9092 |
| NPI Number | 1457901340 |
|---|---|
| Provider Enumeration Date | 09/12/2019 |
| Last Update Date | 11/18/2021 |
| Certification Date | 11/18/2021 |
| Medicare PECOS PAC ID | 4385057512 |
|---|---|
| Medicare Enrollment ID | O20210108000007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457901340 | NPI | - | NPPES |
| Provider Name | Mercy O Oyerinde |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679921886 PECOS PAC ID: 7618260712 Enrollment ID: I20160727001477 |
| Provider Name | Melissa M Gray |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457839219 PECOS PAC ID: 3476882259 Enrollment ID: I20190903002927 |
| Provider Name | Ebote Ngite Nnoko |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346871696 PECOS PAC ID: 0547699662 Enrollment ID: I20200410000197 |
| Provider Name | Beatrice Odero |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194358754 PECOS PAC ID: 9436571130 Enrollment ID: I20200625003157 |
| Provider Name | Lori D Thornton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407464183 PECOS PAC ID: 9638597842 Enrollment ID: I20200918002098 |
| Provider Name | Raven R Bailey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891177416 PECOS PAC ID: 9436563905 Enrollment ID: I20210122002580 |
| Provider Name | Carly Marie Farrell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730729112 PECOS PAC ID: 6709290596 Enrollment ID: I20210208001345 |
| Provider Name | Anthony Hall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558904169 PECOS PAC ID: 9436564085 Enrollment ID: I20221127000031 |
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