MEDICARE: NURTURE & THRIVE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist

General Provider Information

NPI Number	:	1669320768
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NURTURE & THRIVE LLC

Provider Business Mailing Address
First Line	:	560 SYLVAN AVE STE 1065
Second Line	:
City	:	ENGLEWOOD CLIFFS
State	:	NJ
Zip	:	07632-3161
Country	:	US
Telephone Number	:	201-477-0058
Fax Number	:

Provider Business Practice Location Address
First Line	:	560 SYLVAN AVE STE 1065
Second Line	:
City	:	ENGLEWOOD CLIFFS
State	:	NJ
Zip	:	07632-3161
Country	:	US
Telephone Number	:	201-477-0058
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ERICA PEPOSE
Credential	:	PSY.D.
Telephone Number	:	973-953-3070

Provider Enumeration Date	:	03/17/2026
Last Update Date	:	04/19/2026

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