THRIVEWORKS CLINICAL - FLORIDA INC
Complete NPI Record 1396360996
Counselor - Mental Health in Fort Lauderdale, FL
Active since June 10, 2020
Complete NPI Dataset
This page contains the complete raw NPPES record for Thriveworks Clinical - Florida Inc (NPI 1396360996), a counselor organization in Fort Lauderdale, FL. All 30 fields on file are listed with their current values and official NPPES definitions, exactly as recorded in the National Plan and Provider Enumeration System. Only fields that contain data are included, so the number of fields shown varies from one NPI record to another.
Use the tools below to filter fields by category, search within the record, or jump straight to a specific field. You can download the full record as a CSV, JSON, Markdown or text file, or filter first and export only the fields you need. The Print Clean Summary button produces a printer-friendly copy of the record.
Registry File Document Utilities
- NPI: 1396360996 Field 1/30
- The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
- Entity Type Code: 2 Field 2/30
- Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
- Employer Identification Number EIN: Not available Field 3/30
- The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
- Provider Organization Name Legal Business Name: THRIVEWORKS CLINICAL - FLORIDA INC Field 4/30
- The name of the organization provider. If the provider is an organization, this is the legal business name.
- Provider Other Organization Name: Not available Field 5/30
- Other name by which the organization provider is or has been known.
- Provider Other Organization Name Type Code: 6 Field 6/30
- Code identifying the type of other name. Codes are: 1 = former name; 2 = professional name; 3 = doing business as (d/b/ a) name; 4 = former legal business name; 5 = other.
- Provider First Line Business Mailing Address: PO BOX 748465 Field 7/30
- The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
- Provider Business Mailing Address City Name: ATLANTA Field 8/30
- The city name in the mailing address of the provider being identified.
- Provider Business Mailing Address State Name: GA Field 9/30
- The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
- Provider Business Mailing Address Postal Code: 303748465 Field 10/30
- The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
- Provider Business Mailing Address Country Code If outside U S : US Field 11/30
- The country code in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address country code".
- Provider Business Mailing Address Telephone Number: 8552847483 Field 12/30
- The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
- Provider First Line Business Practice Location Address: 2425 E COMMERCIAL BLVD STE 405 Field 13/30
- The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
- Provider Business Practice Location Address City Name: FORT LAUDERDALE Field 14/30
- The city name in the location address of the provider being identified.
- Provider Business Practice Location Address State Name: FL Field 15/30
- The State code in the location of the provider being identified.
- Provider Business Practice Location Address Postal Code: 333084029 Field 16/30
- The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
- Provider Business Practice Location Address Country Code If outside U S : US Field 17/30
- The country code in the location address of the provider being identified.
- Provider Business Practice Location Address Telephone Number: 7544005514 Field 18/30
- The telephone number associated with the location address of the provider being identified.
- Authorized Official Last Name: MILLER Field 21/30
- The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
- Authorized Official First Name: NATHAN Field 22/30
- The first name of the authorized official.
- Authorized Official Middle Name: M Field 23/30
- The middle name of the authorized official.
- Authorized Official Title or Position: OWNER Field 24/30
- The title or position of the authorized official.
- Authorized Official Telephone Number: 5402176461 Field 25/30
- The 10-position telephone number of the authorized official.
- Healthcare Provider Taxonomy Code 1: 101YM0800X Field 26/30
- This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
- Healthcare Provider Primary Taxonomy Switch 1: Y Field 27/30
- This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
- Is Organization Subpart: N Field 28/30
- Indicates whether the provider is a subpart of a larger organization. This is a single-character code: "Y" means the entity is an organizational subpart, while "N" means it is not. Subparts typically include hospital departments, clinics, or other distinct units that fall under a parent organization.
- Healthcare Provider Taxonomy Group 1: 193200000X MULTI-SPECIALTY GROUP Field 29/30
- Specifies whether the provider is part of a single-specialty or multi-specialty business group. The possible values are: 193200000X – Multi-Specialty Group or 193400000X – Single Specialty Group. This field helps distinguish the organizational structure of a provider group.
Other Organization Names 1
Additional business and trade names this provider has on file with the NPPES registry.
Thriveworks Other Name
Name 1/1Other Name: Any additional name associated with either an individual provider or an organization that does not fall under the other defined name type categories.
Secondary Practice Locations 13
The first line of the secondary practice location address of the provider being identified. For providers with more than one physical location, this is a secondary practice location address. This address cannot include a Post Office box.
4115 W Spruce St Ste 205
Location 1/13Tampa, FL 33607-2485 · Phone (855) 284-7483
1601 Belvedere Rd Ste S204
Location 2/13West Palm Beach, FL 33406-1541 · Phone (855) 284-7483
10100 W Sample Rd Ste 205
Location 3/13Coral Springs, FL 33065-3975 · Phone (855) 284-7483
501 S Lincoln Ave Ste 24
Location 4/13Clearwater, FL 33756-5964 · Phone (855) 284-7483
7593 W Boynton Beach Blvd Ste 120
Location 5/13Boynton Beach, FL 33437-6161 · Phone (855) 284-7483
7999 N Federal Hwy Ste 200
Location 6/13Boca Raton, FL 33487-1673 · Phone (855) 284-7483
2852 Remington Green Cir Ste 203
Location 7/13Tallahassee, FL 32308-1507 · Phone (855) 284-7483
6150 Metrowest Blvd Ste 305
Location 8/13Orlando, FL 32835-3291 · Phone (855) 284-7483
2700 Westhall Ln Ste 118
Location 9/13Maitland, FL 32751-7451 · Phone (855) 284-7483
4070 Herschel St Ste 1
Location 10/13Jacksonville, FL 32210-2239 · Phone (904) 567-7203
2924 Davie Rd Ste 103
Location 11/13Davie, FL 33314-1615 · Phone (855) 284-7483
4243 Sunbeam Rd Ste 1
Location 12/13Jacksonville, FL 32257-8975 · Phone (855) 284-7483
4210 NW 37th Pl Ste 700
Location 13/13Gainesville, FL 32606-7702 · Phone (855) 284-7483
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