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General NPI Number Information
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NPI Number | 1033901137
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Entity Type | Organization
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Legal Business Name | THRIVING MINDS PLLC
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Dates
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Enumeration Date | 05/22/2025
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Last Update Date | 05/27/2025
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Provider Practice Location Address
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Address Line | 4300 MARSH LANDING BLVD STE 204
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City | JACKSONVILLE BEACH
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State | FL
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Zip | 32250-1420
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Country | US
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Telephone | 904-796-1791
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Fax |
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Provider Business Mailing Address
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Address Line | 12620 BEACH BLVD ST 3-412
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City | JACKSONVILLE
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State | FL
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Zip | 32246
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Country | US
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Telephone | 904-796-1791
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Fax |
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Authorized Official
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Title or Position | LCSW,OWNER OF ENTITY
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Name | SYMA KHAN
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Credential | LCSW
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Telephone | 904-599-3226
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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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