Healthcare Provider Details
I. General information
NPI: 1689292963
Provider Name (Legal Business Name): THRIVE BEHAVIORAL SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/13/2020
Last Update Date: 07/17/2025
Certification Date: 07/17/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
15048 14TH ST
DADE CITY FL
33523-2503
US
IV. Provider business mailing address
15048 14TH ST
DADE CITY FL
33523-2503
US
V. Phone/Fax
- Phone: 352-232-8997
- Fax: 833-422-0029
- Phone: 352-232-8997
- Fax: 833-422-0029
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 106S00000X |
| Taxonomy | Behavior Technician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
KAELYN
MEINERT
Title or Position: BCBA
Credential: M.A., BCBA
Phone: 724-766-9405