Provider Demographics
NPI:1548986599
Name:THRIVING MENTAL HEALTH COUNSELING PLLC
Entity type:Organization
Organization Name:THRIVING MENTAL HEALTH COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:ALICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:GOMERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:929-400-3868
Mailing Address - Street 1:8315 LEFFERTS BLVD APT 4L
Mailing Address - Street 2:
Mailing Address - City:KEW GARDENS
Mailing Address - State:NY
Mailing Address - Zip Code:11415-2541
Mailing Address - Country:US
Mailing Address - Phone:192-940-0386
Mailing Address - Fax:
Practice Address - Street 1:8315 LEFFERTS BLVD APT 4L
Practice Address - Street 2:
Practice Address - City:KEW GARDENS
Practice Address - State:NY
Practice Address - Zip Code:11415-2541
Practice Address - Country:US
Practice Address - Phone:192-940-0386
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-12
Last Update Date:2022-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty