Provider Demographics
NPI:1043836505
Name:GROUNDED THERAPY, A PSYCHOLOGY CORP
Entity Type:Organization
Organization Name:GROUNDED THERAPY, A PSYCHOLOGY CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO AND LICENSED PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:STACY
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:BONDS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:858-367-7274
Mailing Address - Street 1:374 N COAST HIGHWAY 101
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-2542
Mailing Address - Country:US
Mailing Address - Phone:858-208-0380
Mailing Address - Fax:
Practice Address - Street 1:374 N COAST HIGHWAY 101
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-2542
Practice Address - Country:US
Practice Address - Phone:858-208-0380
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-22
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty