Provider Demographics
NPI:1649098161
Name:THRIVE THERAPEUTIC SERVICES, LLC
Entity type:Organization
Organization Name:THRIVE THERAPEUTIC SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / CEO
Authorized Official - Prefix:
Authorized Official - First Name:BRITTANY
Authorized Official - Middle Name:
Authorized Official - Last Name:PRUITT
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:501-302-1453
Mailing Address - Street 1:418 S ROCK ST
Mailing Address - Street 2:
Mailing Address - City:SHERIDAN
Mailing Address - State:AR
Mailing Address - Zip Code:72150-7063
Mailing Address - Country:US
Mailing Address - Phone:501-302-1453
Mailing Address - Fax:501-302-9302
Practice Address - Street 1:418 S ROCK ST
Practice Address - Street 2:
Practice Address - City:SHERIDAN
Practice Address - State:AR
Practice Address - Zip Code:72150-7063
Practice Address - Country:US
Practice Address - Phone:501-302-1453
Practice Address - Fax:501-302-9302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-02
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR281214719Medicaid