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General NPI Number Information
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NPI Number | 1619693256
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Entity Type | Organization
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Legal Business Name | THRIVE MIND HEALTH INC.
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Dates
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Enumeration Date | 10/14/2022
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Last Update Date | 06/04/2025
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Provider Practice Location Address
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Address Line | 15445 VENTURA BLVD. SUITE 5, BOX # 257
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City | SHERMAN OAKS
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State | CA
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Zip | 91403
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Country | US
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Telephone | 818-342-5050
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Fax |
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Provider Business Mailing Address
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Address Line | 15445 VENTURA BLVD. SUITE 5, BOX # 257
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City | SHERMAN OAKS
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State | CA
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Zip | 91403
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Country | US
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Telephone | 818-342-5050
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. MAGED BOTROS
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Credential | MD
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Telephone | 818-342-5050
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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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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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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