Thriveworks | |
100 5th St Ste 310 Bristol TN 37620-5919 | |
(423) 822-5099 | |
Not Available |
Full Name | Thriveworks |
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Speciality | Counselor |
Location | 100 5th St Ste 310, Bristol, Tennessee |
Authorized Official Name and Position | Harland Clayton Harris (OWNER) |
Authorized Official Contact | 4235736836 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Thriveworks 1020 N Sugartree Ln Gallatin TN 37066-8564 Ph: (423) 573-6836 | Thriveworks 100 5th St Ste 310 Bristol TN 37620-5919 Ph: (423) 822-5099 |
NPI Number | 1790106979 |
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Provider Enumeration Date | 12/14/2013 |
Last Update Date | 02/20/2021 |
Certification Date | 02/20/2021 |
Medicare PECOS PAC ID | 5597989533 |
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Medicare Enrollment ID | O20140613002012 |
Identifier | Type | State | Issuer |
---|---|---|---|
1790106979 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YA0400X | Counselor - Addiction (substance Use Disorder) | 1141 (Tennessee) | Secondary |
101YP2500X | Counselor - Professional | 3137 (Tennessee) | Primary |
Provider Name | Mark S Kryter |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1376569988 PECOS PAC ID: 5597740043 Enrollment ID: I20040621000417 |
Provider Name | Nicola J Bone |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1518138866 PECOS PAC ID: 8729158787 Enrollment ID: I20080602000925 |
Provider Name | Anne M Little-goss |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1487779476 PECOS PAC ID: 8426189085 Enrollment ID: I20100625000035 |
Provider Name | Sarah G Mccray |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1114174505 PECOS PAC ID: 5193047736 Enrollment ID: I20141209002077 |
Provider Name | Lindsey L Chandler |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1750650339 PECOS PAC ID: 1658682398 Enrollment ID: I20150622001277 |
Provider Name | Kindril L Climer |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1841759263 PECOS PAC ID: 1456689165 Enrollment ID: I20190820000192 |
Provider Name | Kaleb Pratt |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1760039929 PECOS PAC ID: 2961892773 Enrollment ID: I20211210000813 |
Provider Name | Amanda Domangue Bourg |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1386758068 PECOS PAC ID: 5193119030 Enrollment ID: I20220218001332 |
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