NPI Code Details Logo

NPI 1841154424

NPI 1841154424 : THRIVE MIAMI, LLC : PALMETTO BAY, FL

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1841154424
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    THRIVE MIAMI, LLC 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    12/09/2025
-----------------------------------------------------
    Last Update Date     |    12/09/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    17020 SW 92ND CT 
-----------------------------------------------------
    City                 |    PALMETTO BAY
-----------------------------------------------------
    State                |    FL
-----------------------------------------------------
    Zip                  |    33157-4543
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    305-815-6028
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    17020 SW 92ND CT 
-----------------------------------------------------
    City                 |    PALMETTO BAY
-----------------------------------------------------
    State                |    FL
-----------------------------------------------------
    Zip                  |    33157-4543
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    305-815-6028
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    OWNER
-----------------------------------------------------
    Name                 |     JENNIFER  CARLO 
-----------------------------------------------------
    Credential           |    LMHC
-----------------------------------------------------
    Telephone            |    305-815-6028
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    101YM0800X
-----------------------------------------------------
    Taxonomy Name        |    Mental Health Counselor
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
    Taxonomy Code        |    103K00000X
-----------------------------------------------------
    Taxonomy Name        |    Behavior Analyst
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
    Taxonomy Code        |    208100000X
-----------------------------------------------------
    Taxonomy Name        |    Physical Medicine & Rehabilitation Physician
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #4
-----------------------------------------------------
    Taxonomy Code        |    225100000X
-----------------------------------------------------
    Taxonomy Name        |    Physical Therapist
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #5
-----------------------------------------------------
    Taxonomy Code        |    225X00000X
-----------------------------------------------------
    Taxonomy Name        |    Occupational Therapist
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #6
-----------------------------------------------------
    Taxonomy Code        |    225XP0019X
-----------------------------------------------------
    Taxonomy Name        |    Physical Rehabilitation Occupational Therapist
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #7
-----------------------------------------------------
    Taxonomy Code        |    261QM0801X
-----------------------------------------------------
    Taxonomy Name        |    Mental Health Clinic/Center (Including Community Mental Health Center)
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------



                        

Copyright © 2007-2025 Data Labs Health. All rights reserved.