=====================================================
General NPI Number Information
=====================================================
NPI Number | 1083504153
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | THRIVING MENTAL HEALTH COUNSELING NY PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/08/2025
-----------------------------------------------------
Last Update Date | 07/08/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 595 BLOSSOM RD STE 301A
-----------------------------------------------------
City | ROCHESTER
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 14610-1870
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 585-484-1822
-----------------------------------------------------
Fax | 844-792-8133
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 300 HYLAN DR STE 6-119
-----------------------------------------------------
City | ROCHESTER
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 14623-4216
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 585-484-1822
-----------------------------------------------------
Fax | 844-792-8133
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | RYAN SFORZA
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 585-484-1822
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------