=====================================================
General NPI Number Information
=====================================================
NPI Number | 1386015295
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | THRIVE AUTISM COLLABORATIVE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/19/2015
-----------------------------------------------------
Last Update Date | 09/05/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3501 BLAKE ST STE 210
-----------------------------------------------------
City | DENVER
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80205-4889
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 303-304-6819
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3501 BLAKE ST STE 210
-----------------------------------------------------
City | DENVER
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80205-4889
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 303-304-6819
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | EXECUTIVE DIRECTOR
-----------------------------------------------------
Name | KRYSTEN RAMSEY
-----------------------------------------------------
Credential | BCBA
-----------------------------------------------------
Telephone | 303-304-6819
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103K00000X
-----------------------------------------------------
Taxonomy Name | Behavior Analyst
-----------------------------------------------------
License Number | 1-14-10351
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------