Provider Demographics
NPI:1033901137
Name:THRIVING MINDS PLLC
Entity type:Organization
Organization Name:THRIVING MINDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LCSW,OWNER OF ENTITY
Authorized Official - Prefix:
Authorized Official - First Name:SYMA
Authorized Official - Middle Name:
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:904-599-3226
Mailing Address - Street 1:12620 BEACH BLVD
Mailing Address - Street 2:ST 3-412
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32246
Mailing Address - Country:US
Mailing Address - Phone:904-796-1791
Mailing Address - Fax:
Practice Address - Street 1:4300 MARSH LANDING BLVD STE 204
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE BEACH
Practice Address - State:FL
Practice Address - Zip Code:32250-1420
Practice Address - Country:US
Practice Address - Phone:904-796-1791
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-22
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty