Healthcare Provider Details

I. General information

NPI: 1033075460
Provider Name (Legal Business Name): THRIVE THERAPEUTIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/30/2025
Last Update Date: 12/30/2025
Certification Date: 12/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11777 MANOR LAKE DR
INDEPENDENCE KY
41051-9716
US

IV. Provider business mailing address

11777 MANOR LAKE DR
INDEPENDENCE KY
41051-9716
US

V. Phone/Fax

Practice location:
  • Phone: 513-473-8436
  • Fax:
Mailing address:
  • Phone: 513-473-8436
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: LAUREN MICKAELA RUNYON
Title or Position: THERAPIST
Credential: LCSW, LISW
Phone: 859-587-2995