MEDICARE: THRIVE AUTISM SERVICES, 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	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1891365458
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THRIVE AUTISM SERVICES, PLLC

Provider Business Mailing Address
First Line	:	2122 E HIGHLAND AVE STE 420
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85016-4739
Country	:	US
Telephone Number	:	425-503-1679
Fax Number	:	480-933-0048

Provider Business Practice Location Address
First Line	:	3592 S ATHERTON BLVD STE 101
Second Line	:
City	:	GILBERT
State	:	AZ
Zip	:	85297-7444
Country	:	US
Telephone Number	:	480-269-0786
Fax Number	:	480-933-0048

Authorized Official
Title or Position	:	CFO
Name	:	CHRISTINE PETER
Credential	:
Telephone Number	:	480-269-0786

Provider Enumeration Date	:	06/27/2021
Last Update Date	:	04/18/2025

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