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General NPI Number Information
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NPI Number | 1336898758
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Entity Type | Organization
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Legal Business Name | TOP THRIVE THERAPY, LLC
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Dates
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Enumeration Date | 03/22/2022
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Last Update Date | 03/22/2022
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Provider Practice Location Address
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Address Line | 4445 CORPORATION LN STE 264
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City | VIRGINIA BEACH
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State | VA
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Zip | 23462-3262
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Country | US
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Telephone | 954-284-0502
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Fax |
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Provider Business Mailing Address
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Address Line | 605 NE 9TH AVE APT 1
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City | FORT LAUDERDALE
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State | FL
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Zip | 33304-4732
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Country | US
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Telephone | 954-284-0502
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SAYURI JULIE HEINL
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Credential | LMFT
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Telephone | 954-284-0502
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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