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General NPI Number Information
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NPI Number | 1861060543
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Entity Type | Organization
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Legal Business Name | THRIVE PSYCHOLOGY PLLC
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Dates
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Enumeration Date | 06/17/2021
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Last Update Date | 07/27/2021
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Provider Practice Location Address
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Address Line | 405 N WASHINGTON ST STE 102
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City | FALLS CHURCH
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State | VA
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Zip | 22046-3410
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Country | US
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Telephone | 703-609-6030
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Fax |
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Provider Business Mailing Address
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Address Line | 405 N WASHINGTON ST STE 102
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City | FALLS CHURCH
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State | VA
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Zip | 22046-3410
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Country | US
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Telephone | 703-952-9432
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Fax |
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Authorized Official
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Title or Position | LICENSED CLINICAL PSYCHOLOGIST
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Name | DR. PAIGE E FEGAN
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Credential | PSY.D., M.ED.
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Telephone | 703-952-9432
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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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