MEDICARE: THRIVE PSYCHOTHERAPEUTIC SERVICES LLC

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	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1669367389
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THRIVE PSYCHOTHERAPEUTIC SERVICES LLC

Provider Business Mailing Address
First Line	:	5840 N ORCHARD CREEK CIR
Second Line	:
City	:	BOULDER
State	:	CO
Zip	:	80301-5834
Country	:	US
Telephone Number	:	303-859-2654
Fax Number	:

Provider Business Practice Location Address
First Line	:	80 GARDEN CTR STE 128
Second Line	:
City	:	BROOMFIELD
State	:	CO
Zip	:	80020-2622
Country	:	US
Telephone Number	:	720-728-8908
Fax Number	:

Authorized Official
Title or Position	:	OWNER/PSYCHOTHERAPIST
Name	:	MISS BRYNN MILLER
Credential	:	LPC
Telephone Number	:	303-859-2654

Provider Enumeration Date	:	06/11/2025
Last Update Date	:	06/11/2025

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