Healthcare Provider Details

I. General information

NPI: 1235093717
Provider Name (Legal Business Name): THRIVE PEDIATRIC THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2025
Last Update Date: 03/31/2026
Certification Date: 03/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

580 SPRINGRIDGE RD STE D3
CLINTON MS
39056-5671
US

IV. Provider business mailing address

115 CALLAWAY CIR
BYRAM MS
39272-4500
US

V. Phone/Fax

Practice location:
  • Phone: 601-345-6326
  • Fax: 601-368-6788
Mailing address:
  • Phone: 601-345-6326
  • Fax: 601-368-6788

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: BRIANA HARVEY
Title or Position: OWNER
Credential: SLP
Phone: 769-233-4041