| Thriveworks | |
|
770 N Halsted St Ste 201b Chicago IL 60642-5999 | |
| (855) 284-7483 | |
| Not Available |
| Full Name | Thriveworks |
|---|---|
| Speciality | Counselor |
| Location | 770 N Halsted St Ste 201b, Chicago, Illinois |
| Authorized Official Name and Position | Anthony Centore (CEO) |
| 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 770 N Halsted St Ste 201b Chicago IL 60642-5999 Ph: (855) 284-7483 |
| NPI Number | 1154099620 |
|---|---|
| Provider Enumeration Date | 08/31/2021 |
| Last Update Date | 01/14/2022 |
| Certification Date | 01/11/2022 |
| Medicare PECOS PAC ID | 4587035225 |
|---|---|
| Medicare Enrollment ID | O20230117002207 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154099620 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Scott Moore Gordon |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1821038159 PECOS PAC ID: 5799715413 Enrollment ID: I20050812000619 |
| Provider Name | Lori A Hopwood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588976930 PECOS PAC ID: 9234390873 Enrollment ID: I20120409000418 |
| Provider Name | Jacqueline Ann Bode |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245572213 PECOS PAC ID: 5597980094 Enrollment ID: I20140625000877 |
| Provider Name | Wanda Cegers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902440969 PECOS PAC ID: 8123434537 Enrollment ID: I20210310000771 |
| Provider Name | Shannan M Hermann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811569767 PECOS PAC ID: 1153727672 Enrollment ID: I20210909000610 |
| Provider Name | Aneel Ursani |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1982085676 PECOS PAC ID: 3577863232 Enrollment ID: I20211230001065 |
| Provider Name | Joseph A Hanson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1831546787 PECOS PAC ID: 6800227588 Enrollment ID: I20220427002937 |
| Provider Name | Anh Nguyen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508437484 PECOS PAC ID: 0648667162 Enrollment ID: I20220429001985 |
| Provider Name | Olukemi Aina |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124787650 PECOS PAC ID: 7810389699 Enrollment ID: I20230102000159 |
| Provider Name | Jodie Lynn Warsing |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639116767 PECOS PAC ID: 1850396821 Enrollment ID: I20230412000275 |
| Provider Name | Medinat O Balogun |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558964239 PECOS PAC ID: 5597119248 Enrollment ID: I20230928001927 |
| Provider Name | Barbara Ann Center |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1497909147 PECOS PAC ID: 5890781017 Enrollment ID: I20231211003287 |
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