Healthcare Provider Details

I. General information

NPI: 1902335029
Provider Name (Legal Business Name): THRIVE INTEGRATIVE PSYCHIATRY AND SEXUALITY COUNSELING ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2017
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 CENTER ST
NORTHAMPTON MA
01060-3405
US

IV. Provider business mailing address

448 SMITH RD
ASHFIELD MA
01330-9503
US

V. Phone/Fax

Practice location:
  • Phone: 413-446-3915
  • Fax: 413-446-3915
Mailing address:
  • Phone: 413-628-3363
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number149071
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number178157
License Number StateMA

VIII. Authorized Official

Name: ROBIN RIVINUS
Title or Position: PARTNER
Credential: PNP, CNM,MS
Phone: 413-628-3363