# THRIVEWORKS CLINICAL - NORTH DAKOTA PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194422014
- **Authorized official:** ANTHONY CENTORE CEO (CEO)
- **Authorized official phone:** (540) 217-6461

## Contact information

- **Practice address:** 3245 42ND ST S STE 100, FARGO, ND 58104-7178
- **Practice address phone:** (855) 284-7483
- **Mailing address:** PO BOX 748465, ATLANTA, GA 30374-8465
- **Mailing address phone:** (855) 284-7483

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | Yes |
| 101YM0800X | Mental Health Counselor | — | — | Yes |

## Other

- **Enumeration date:** 02/10/2023
- **Last updated:** 02/10/2023