MEDICARE: THRIVING MINDS PSYCHIATRY & CONVENIENCE CARE PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1235063942
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THRIVING MINDS PSYCHIATRY & CONVENIENCE CARE PLLC

Provider Business Mailing Address
First Line	:	4045 PREMIER DR STE 101
Second Line	:
City	:	HIGH POINT
State	:	NC
Zip	:	27265-9431
Country	:	US
Telephone Number	:	336-420-1441
Fax Number	:

Provider Business Practice Location Address
First Line	:	4045 PREMIER DR STE 101
Second Line	:
City	:	HIGH POINT
State	:	NC
Zip	:	27265-9431
Country	:	US
Telephone Number	:	336-420-1441
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	SE HYANG HAN
Credential	:
Telephone Number	:	336-420-1441

Provider Enumeration Date	:	06/09/2026
Last Update Date	:	06/09/2026

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