Provider Demographics
NPI:1053171629
Name:THRIVE MENTAL HEALTH LLC
Entity type:Organization
Organization Name:THRIVE MENTAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:HUTCHINS
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:337-277-7495
Mailing Address - Street 1:4 PEBBLESTONE DR
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-4923
Mailing Address - Country:US
Mailing Address - Phone:337-277-7495
Mailing Address - Fax:
Practice Address - Street 1:203 ENERGY PKWY UNIT 2
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-3815
Practice Address - Country:US
Practice Address - Phone:337-205-9725
Practice Address - Fax:337-234-7111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-20
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA231235OtherSTATE LICENSE
LA1114605144OtherINDIVIDUAL PROVIDER NPI