Organization
TRIBE513, P.A.
Active
Other names
Vive Psych
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIE CLEVELAND (DIRECTOR)
(970) 471-2922
Entity
Organization
Contact information
Practice address
127 W ANTRIM DR, GREENVILLE, SC 29607-2505
(864) 239-4110
Mailing address
127 W ANTRIM DR, GREENVILLE, SC 29607-2505
(864) 239-4110
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
103TE1100X
Exercise & Sports Psychologist
—
—
103TS0200X
School Psychologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1053778431
NPI
—
01
—
1356604466
NPI
—
01
—
1942631189
NPI
—
Enumeration date
02/24/2020
Last updated
04/19/2024
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