Healthcare Provider Details

I. General information

NPI: 1720906795
Provider Name (Legal Business Name): THRIVING MIND OF NEW YORK, LCSW PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 W 24TH ST APT 4H
NEW YORK NY
10011-1562
US

IV. Provider business mailing address

311 W 24TH ST APT 4H
NEW YORK NY
10011-1562
US

V. Phone/Fax

Practice location:
  • Phone: 551-795-8246
  • Fax:
Mailing address:
  • Phone: 551-795-8246
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MARISA MARKOWITZ
Title or Position: FOUNDER
Credential: LCSW
Phone: 201-341-2619