Healthcare Provider Details

I. General information

NPI: 1497640981
Provider Name (Legal Business Name): THRIVE PSYCHOTHERAPEUTIC SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2025
Last Update Date: 06/12/2025
Certification Date: 06/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5485 CONESTOGA CT # 100G
BOULDER CO
80301-2752
US

IV. Provider business mailing address

5840 N ORCHARD CREEK CIR
BOULDER CO
80301-5834
US

V. Phone/Fax

Practice location:
  • Phone: 720-728-8909
  • Fax:
Mailing address:
  • Phone: 303-859-2654
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: BRYNN MILLER
Title or Position: OWNER/PSYCHOTHERAPIST
Credential:
Phone: 303-859-2654