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General NPI Number Information
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NPI Number | 1033075460
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Entity Type | Organization
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Legal Business Name | THRIVE THERAPEUTIC LLC
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Dates
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Enumeration Date | 12/30/2025
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Last Update Date | 12/30/2025
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Provider Practice Location Address
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Address Line | 11777 MANOR LAKE DR
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City | INDEPENDENCE
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State | KY
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Zip | 41051-9716
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Country | US
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Telephone | 513-473-8436
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Fax |
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Provider Business Mailing Address
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Address Line | 11777 MANOR LAKE DR
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City | INDEPENDENCE
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State | KY
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Zip | 41051-9716
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Country | US
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Telephone | 513-473-8436
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | LAUREN MICKAELA RUNYON
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Credential | LCSW, LISW
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Telephone | 859-587-2995
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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