Provider Demographics
NPI:1902235096
Name:ELIZABETH MARADONA, LMHC, P.A.
Entity Type:Organization
Organization Name:ELIZABETH MARADONA, LMHC, P.A.
Other - Org Name:THRIVE THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:MARADONA
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:239-938-4428
Mailing Address - Street 1:2734 OAK RIDGE CT
Mailing Address - Street 2:UNIT 404
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33901-9369
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2734 OAK RIDGE CT
Practice Address - Street 2:UNIT 404
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33901-9369
Practice Address - Country:US
Practice Address - Phone:239-938-4428
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-08
Last Update Date:2013-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH11995101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty