| Thrive Mental Health | |
|
5016 W Genesee St Camillus NY 13031-2356 | |
| (315) 320-7900 | |
| Not Available |
| Full Name | Thrive Mental Health |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 5016 W Genesee St, Camillus, New York |
| Authorized Official Name and Position | Kevin Johnson (OWNER) |
| Authorized Official Contact | 3153207900 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Thrive Mental Health 5016 W Genesee St Camillus NY 13031-2356 Ph: (315) 320-7900 | Thrive Mental Health 5016 W Genesee St Camillus NY 13031-2356 Ph: (315) 320-7900 |
| NPI Number | 1548892201 |
|---|---|
| Provider Enumeration Date | 02/10/2020 |
| Last Update Date | 07/28/2020 |
| Certification Date | 07/28/2020 |
| Medicare PECOS PAC ID | 5890113864 |
|---|---|
| Medicare Enrollment ID | O20200909000243 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548892201 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Kevin Johnson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1396155511 PECOS PAC ID: 5496067779 Enrollment ID: I20190124003355 |
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