Provider Demographics
NPI:1083390959
Name:CONNECT TO GROWTH PSYCHOTHERAPY LCSW PLLC
Entity Type:Organization
Organization Name:CONNECT TO GROWTH PSYCHOTHERAPY LCSW PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDING & MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:
Authorized Official - Last Name:STUART-CAINES
Authorized Official - Suffix:
Authorized Official - Credentials:LCSWR
Authorized Official - Phone:718-502-6486
Mailing Address - Street 1:34 PLAZA ST E P109
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11238
Mailing Address - Country:US
Mailing Address - Phone:718-502-6486
Mailing Address - Fax:718-223-5643
Practice Address - Street 1:34 PLAZA ST E P109
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11238
Practice Address - Country:US
Practice Address - Phone:718-502-6486
Practice Address - Fax:718-223-5643
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-26
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty