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General NPI Number Information
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NPI Number | 1780078402
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Entity Type | Organization
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Legal Business Name | THRIVE PSYCHOLOGICAL SERVICES PLLC
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Dates
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Enumeration Date | 03/19/2015
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Last Update Date | 03/19/2015
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Provider Practice Location Address
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Address Line | 19 W 34TH ST PH FLOOR
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City | NEW YORK
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State | NY
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Zip | 10001-3006
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Country | US
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Telephone | 646-504-2873
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Fax |
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Provider Business Mailing Address
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Address Line | 19 W 34TH ST PH FLOOR
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City | NEW YORK
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State | NY
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Zip | 10001-3006
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Country | US
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Telephone | 646-504-2873
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Fax |
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | DR. JONATHAN A BELFORD
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Credential | PSYD
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Telephone | 646-504-2873
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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 | 0195381
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License Number State | NY
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