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General NPI Number Information
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NPI Number | 1194223651
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Entity Type | Organization
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Legal Business Name | THRIVE BEHAVIORAL CONSULTANTS LLC
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Dates
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Enumeration Date | 01/30/2018
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Last Update Date | 01/30/2018
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Provider Practice Location Address
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Address Line | 101 REEDY VIEW DR APT 445
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City | GREENVILLE
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State | SC
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Zip | 29601-1876
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Country | US
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Telephone | 843-227-0861
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1628
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City | BLUFFTON
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State | SC
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Zip | 29910-1628
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Country | US
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Telephone | 843-227-0861
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Fax | 843-815-2835
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Authorized Official
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Title or Position | OWNER
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Name | MEGAN N NASTOFF
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Credential | BCBA
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Telephone | 843-227-0861
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106E00000X
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Taxonomy Name | Assistant Behavior Analyst
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License Number |
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License Number State |
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