Healthcare Provider Details

I. General information

NPI: 1629565908
Provider Name (Legal Business Name): THRIVE WELLNESS OF RENO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2018
Last Update Date: 05/11/2023
Certification Date: 05/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

491 COURT ST
RENO NV
89501-1708
US

IV. Provider business mailing address

491 COURT ST
RENO NV
89501-1708
US

V. Phone/Fax

Practice location:
  • Phone: 775-525-8103
  • Fax:
Mailing address:
  • Phone: 775-525-8103
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KATHRYN GEIGER
Title or Position: CEO
Credential: LCSW
Phone: 510-501-5260