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NPI 1861375719

NPI 1861375719 : THRIVE INTEGRATED NEUROPSYCHOLOGICAL SERVICES : POOLER, GA

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General NPI Number Information
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    NPI Number           |    1861375719
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    Entity Type          |    Organization 
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    Legal Business Name  |    THRIVE INTEGRATED NEUROPSYCHOLOGICAL SERVICES 
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Dates
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    Enumeration Date     |    07/29/2025
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    Last Update Date     |    07/29/2025
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Provider Practice Location Address
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    Address Line         |    231 CHIPPINGWOOD CIR 
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    City                 |    POOLER
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    State                |    GA
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    Zip                  |    31322-3617
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    Country              |    US
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    Telephone            |    305-409-8173
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    231 CHIPPINGWOOD CIR 
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    City                 |    POOLER
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    State                |    GA
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    Zip                  |    31322-3617
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    NEUROPSYCHOLOGIST
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    Name                 |     FERNE ARLENE PINARD 
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    Credential           |    PH.D.
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    Telephone            |    305-409-8173
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    261QM0855X
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    Taxonomy Name        |    Adolescent and Children Mental Health Clinic/Center
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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        |    261QM0801X
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    Taxonomy Name        |    Mental Health Clinic/Center (Including Community Mental Health Center)
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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        |    103G00000X
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    Taxonomy Name        |    Clinical Neuropsychologist
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    License Number       |    
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    License Number State |    
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