Healthcare Provider Details

I. General information

NPI: 1861375719
Provider Name (Legal Business Name): THRIVE INTEGRATED NEUROPSYCHOLOGICAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2025
Last Update Date: 07/29/2025
Certification Date: 07/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

231 CHIPPINGWOOD CIR
POOLER GA
31322-3617
US

IV. Provider business mailing address

231 CHIPPINGWOOD CIR
POOLER GA
31322-3617
US

V. Phone/Fax

Practice location:
  • Phone: 305-409-8173
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: FERNE ARLENE PINARD
Title or Position: NEUROPSYCHOLOGIST
Credential: PH.D.
Phone: 305-409-8173