| Thriveworks Clinical - Indiana Llc | |
|
250 Main St Ste 420 Lafayette IN 47901-1285 | |
| (855) 284-7483 | |
| Not Available |
| Full Name | Thriveworks Clinical - Indiana Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 250 Main St Ste 420, Lafayette, Indiana |
| Authorized Official Name and Position | Anthony Centore (CEO) |
| Authorized Official Contact | 5402176461 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Thriveworks Clinical - Indiana Llc Po Box 748465 Atlanta GA 30374-8465 Ph: (855) 284-7483 | Thriveworks Clinical - Indiana Llc 250 Main St Ste 420 Lafayette IN 47901-1285 Ph: (855) 284-7483 |
| NPI Number | 1497460547 |
|---|---|
| Provider Enumeration Date | 01/23/2023 |
| Last Update Date | 01/23/2023 |
| Certification Date | 01/23/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497460547 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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