| Thriveworks | |
|
310 E Main Ave Ste 202 Bowling Green KY 42101-2143 | |
| (855) 284-7483 | |
| Not Available |
| Full Name | Thriveworks |
|---|---|
| Speciality | Counselor |
| Location | 310 E Main Ave Ste 202, Bowling Green, Kentucky |
| Authorized Official Name and Position | Nathan Miller (CREDENTIALING AGENT) |
| Authorized Official Contact | 5402176461 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Thriveworks 1000 Jefferson St Ste 2c Lynchburg VA 24504-1724 Ph: (540) 217-6461 | Thriveworks 310 E Main Ave Ste 202 Bowling Green KY 42101-2143 Ph: (855) 284-7483 |
| NPI Number | 1184385841 |
|---|---|
| Provider Enumeration Date | 01/05/2022 |
| Last Update Date | 07/11/2022 |
| Certification Date | 07/11/2022 |
| Medicare PECOS PAC ID | 6406227370 |
|---|---|
| Medicare Enrollment ID | O20230201001128 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184385841 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Raymond Martorano |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1700974540 PECOS PAC ID: 9032288782 Enrollment ID: I20080521000029 |
| Provider Name | Lisa Ann Salyer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811568082 PECOS PAC ID: 6709274160 Enrollment ID: I20211104000733 |
| Provider Name | Jason Rickard |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1275236127 PECOS PAC ID: 6901257492 Enrollment ID: I20240109003160 |
| Provider Name | Mandy West |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1841700069 PECOS PAC ID: 9931509841 Enrollment ID: I20240117001300 |
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