# THRIVE MIND LLC

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

## Provider details

- **NPI number:** 1760257505
- **Authorized official:** ALYSSA SHAFFER (STATUTORY AGENT)
- **Authorized official phone:** (602) 819-0376

## Contact information

- **Practice address:** 16648 N 19TH PL, PHOENIX, AZ 85022-6232
- **Practice address phone:** (602) 819-0376
- **Mailing address:** 16648 N 19TH PL, PHOENIX, AZ 85022-6232
- **Mailing address phone:** (602) 819-0376

## Taxonomy

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

## Other

- **Enumeration date:** 11/21/2023
- **Last updated:** 11/30/2023