Healthcare Provider Details

I. General information

NPI: 1457166134
Provider Name (Legal Business Name): THRIVE PEDIATRIC SPEECH THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/10/2025
Last Update Date: 02/05/2026
Certification Date: 02/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 W 3RD ST
LA JUNTA CO
81050-1512
US

IV. Provider business mailing address

28821 COUNTY ROAD 20.5
ROCKY FORD CO
81067-9447
US

V. Phone/Fax

Practice location:
  • Phone: 719-256-0136
  • Fax: 719-691-7750
Mailing address:
  • Phone: 719-256-0136
  • Fax: 719-691-7750

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: LEIGH PARKER
Title or Position: OWNER
Credential: MS, CCC-SLP
Phone: 719-256-0136