Provider Demographics
NPI:1437751278
Name:GROWTH MINDSET LLC
Entity Type:Organization
Organization Name:GROWTH MINDSET LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIE
Authorized Official - Middle Name:M
Authorized Official - Last Name:VILA
Authorized Official - Suffix:
Authorized Official - Credentials:EDM, LPC
Authorized Official - Phone:732-765-2469
Mailing Address - Street 1:10 MELBOURNE ST
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08817-5313
Mailing Address - Country:US
Mailing Address - Phone:732-379-1822
Mailing Address - Fax:
Practice Address - Street 1:10 MELBOURNE ST
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08817-5313
Practice Address - Country:US
Practice Address - Phone:732-379-1822
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-16
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health