| Thrive Behavioral Health, Llc | |
|
9627 Philadelphia Rd Ste 160 Rosedale MD 21237 | |
| (410) 780-5203 | |
| (410) 780-5205 |
| Full Name | Thrive Behavioral Health, Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 9627 Philadelphia Rd Ste 160, Rosedale, Maryland |
| Authorized Official Name and Position | Elizabeth Anne Hymel (CEO) |
| Authorized Official Contact | 4433076105 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Thrive Behavioral Health, Llc 9627 Philadelphia Rd Ste 160 Rosedale MD 21237-4157 Ph: (410) 780-5203 | Thrive Behavioral Health, Llc 9627 Philadelphia Rd Ste 160 Rosedale MD 21237 Ph: (410) 780-5203 |
| NPI Number | 1053733378 |
|---|---|
| Provider Enumeration Date | 01/07/2014 |
| Last Update Date | 04/30/2019 |
| Medicare PECOS PAC ID | 3476777947 |
|---|---|
| Medicare Enrollment ID | O20140624001948 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053733378 | NPI | - | NPPES |
| 4223195-00 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | MH-1669 (Maryland) | Primary |
| Provider Name | Lonny A Samuels |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619151495 PECOS PAC ID: 3779641980 Enrollment ID: I20081016000364 |
| Provider Name | Julie Marie Brett |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639376122 PECOS PAC ID: 7719027317 Enrollment ID: I20091211000434 |
| Provider Name | Keeley Mccormack Thomas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700970787 PECOS PAC ID: 3072648096 Enrollment ID: I20100316000856 |
| Provider Name | Jesse Callan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124295605 PECOS PAC ID: 6800075128 Enrollment ID: I20110119000494 |
| Provider Name | Stephanie J Goddard |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184861189 PECOS PAC ID: 1456531185 Enrollment ID: I20110211000496 |
| Provider Name | Miguel Macaoay |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1770673048 PECOS PAC ID: 5698941482 Enrollment ID: I20111228000549 |
| Provider Name | Patrick M Mcdonald |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215284815 PECOS PAC ID: 2860640760 Enrollment ID: I20120919000058 |
| Provider Name | Lesley A Ellis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629292032 PECOS PAC ID: 2163641713 Enrollment ID: I20140915001246 |
| Provider Name | Ashlee Mitchell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093114969 PECOS PAC ID: 1355563644 Enrollment ID: I20141121001403 |
| Provider Name | Ganiyat A Adeyemo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588113351 PECOS PAC ID: 7719269745 Enrollment ID: I20170126000912 |
| Provider Name | Janice Doan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356867519 PECOS PAC ID: 5799059374 Enrollment ID: I20170920002070 |
| Provider Name | Heather Rolon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134526411 PECOS PAC ID: 8426324443 Enrollment ID: I20171019000251 |
| Provider Name | Margaret Swink |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013466119 PECOS PAC ID: 3274809959 Enrollment ID: I20171024003507 |
| Provider Name | Ana Maria A Phillips |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366899783 PECOS PAC ID: 5395002984 Enrollment ID: I20171207000765 |
| Provider Name | Jennifer Bambach |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1629502786 PECOS PAC ID: 8527326024 Enrollment ID: I20171211000026 |
| Provider Name | Katherine Todd |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588113864 PECOS PAC ID: 8426310319 Enrollment ID: I20180312001443 |
| Provider Name | Christiana Ikome |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043682685 PECOS PAC ID: 7911217336 Enrollment ID: I20190814000736 |
| Provider Name | Elizabeth Marie Trionfo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891381109 PECOS PAC ID: 0749692333 Enrollment ID: I20201228000406 |
| Provider Name | Ciara Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134741473 PECOS PAC ID: 2961815477 Enrollment ID: I20201230000675 |
| Provider Name | Ericka Williamson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164010419 PECOS PAC ID: 2860805082 Enrollment ID: I20210107002294 |
| Provider Name | Erin Kelmartin Sullivan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073156345 PECOS PAC ID: 4587077664 Enrollment ID: I20210111000189 |
| Provider Name | Colleen Sippel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942898069 PECOS PAC ID: 4486067592 Enrollment ID: I20210111001223 |
| Provider Name | Nekia Jones |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750979597 PECOS PAC ID: 9335552330 Enrollment ID: I20210113000047 |
| Provider Name | Jessica Maritza Calle |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245829522 PECOS PAC ID: 0840603544 Enrollment ID: I20210119000194 |
| Provider Name | Courtney R Bowerman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912567090 PECOS PAC ID: 4789098930 Enrollment ID: I20210128002484 |
| Provider Name | Ann E Ritz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184214868 PECOS PAC ID: 5991119083 Enrollment ID: I20210201002742 |
| Provider Name | Jocelyn Stevens |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184227589 PECOS PAC ID: 4880008978 Enrollment ID: I20210202000001 |
| Provider Name | Deborah Dorsey Gundry |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225638117 PECOS PAC ID: 5799199667 Enrollment ID: I20210204001798 |
| Provider Name | Benjamin Broemm |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619560315 PECOS PAC ID: 1658786090 Enrollment ID: I20210218000038 |
| Provider Name | Jessica Caley Devlin Grisard |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588112478 PECOS PAC ID: 2668887878 Enrollment ID: I20210222001966 |
| Provider Name | Micaela Itter |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871109215 PECOS PAC ID: 5092121566 Enrollment ID: I20210308001579 |
| Provider Name | Ilene L. Brown-fishkind |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255915120 PECOS PAC ID: 3779992300 Enrollment ID: I20210511001117 |
| Provider Name | Elisabeth Turner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326613621 PECOS PAC ID: 6103225909 Enrollment ID: I20210527002092 |
| Provider Name | Emily Porter |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417405721 PECOS PAC ID: 3072916436 Enrollment ID: I20210722000600 |
| Provider Name | Jesse Robertson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306419171 PECOS PAC ID: 1254734478 Enrollment ID: I20210727000050 |
| Provider Name | Adaora U Nnanna |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396294161 PECOS PAC ID: 0143506493 Enrollment ID: I20210913000077 |
| Provider Name | Maria Santina Schrum |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942776455 PECOS PAC ID: 0042618464 Enrollment ID: I20211014002092 |
| Provider Name | Elizabeth Mclendon Gentilcore |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578003562 PECOS PAC ID: 4587053053 Enrollment ID: I20211123000869 |
| Provider Name | Lisa Dollman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548912678 PECOS PAC ID: 5193118586 Enrollment ID: I20220207002626 |
| Provider Name | Tiffany Faith Parks |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093087496 PECOS PAC ID: 2264829100 Enrollment ID: I20220425001422 |
| Provider Name | Gabrielle Fleming |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912573767 PECOS PAC ID: 3476935537 Enrollment ID: I20220805001137 |
| Provider Name | Tiffany Yvette Teel-cottman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376136127 PECOS PAC ID: 8224405386 Enrollment ID: I20221102000092 |
| Provider Name | Andrew Joseph Friend |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235701376 PECOS PAC ID: 0941670319 Enrollment ID: I20221228003241 |
| Provider Name | Noah Jeffrey Shipman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487015590 PECOS PAC ID: 4284088543 Enrollment ID: I20230921000068 |
| Provider Name | Tia L Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902360217 PECOS PAC ID: 0648626408 Enrollment ID: I20231031000213 |
| Provider Name | Kaitlin Simmons-leigh |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447832118 PECOS PAC ID: 0143678227 Enrollment ID: I20231130000307 |
| Provider Name | Katherine Neidorf |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598368995 PECOS PAC ID: 7012321490 Enrollment ID: I20231221002575 |
| Provider Name | Tanya Gooding |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922797554 PECOS PAC ID: 8729439427 Enrollment ID: I20240123002707 |
| Provider Name | Brittany Kahealani Kalahiki |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710655840 PECOS PAC ID: 8426492802 Enrollment ID: I20240214001678 |
| Provider Name | Nkwa Lesedi Mccarthy |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376132928 PECOS PAC ID: 6800232240 Enrollment ID: I20240307004342 |
| Provider Name | Jason Schiren |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1184237117 PECOS PAC ID: 7315383478 Enrollment ID: I20240312000005 |
| Provider Name | Kristin Marie Miller |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1700353976 PECOS PAC ID: 0547606592 Enrollment ID: I20240312003633 |
| Provider Name | Hillary Alexander |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1134677032 PECOS PAC ID: 2961848734 Enrollment ID: I20240314003995 |
| Provider Name | Cierra Jenkins |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1831767151 PECOS PAC ID: 7911344601 Enrollment ID: I20240318000451 |
| Provider Name | Keli S. Smith |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1316956329 PECOS PAC ID: 4688013303 Enrollment ID: I20240415001903 |
| Provider Name | Alexandra Jean Puri |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1639639925 PECOS PAC ID: 7012356322 Enrollment ID: I20240419001141 |
| Provider Name | Meghan Marie Ellis |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1598067050 PECOS PAC ID: 8820437833 Enrollment ID: I20240423002496 |
| Provider Name | Veronica Victoria Weiss |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1225614134 PECOS PAC ID: 5698116762 Enrollment ID: I20240508000063 |
| Provider Name | Jonathan David Phillips |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1962096008 PECOS PAC ID: 6305287269 Enrollment ID: I20240509003808 |
| Provider Name | Nichelle Vanessa Patterson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1629382288 PECOS PAC ID: 3375984602 Enrollment ID: I20240516003307 |
| Provider Name | Jermaine Petit |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1326509860 PECOS PAC ID: 1153762489 Enrollment ID: I20240516003448 |
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