Provider Demographics
NPI:1518053115
Name:GROWTH POINTE COUNSELING SERVICES, LLC
Entity Type:Organization
Organization Name:GROWTH POINTE COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:MORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW,LMFT
Authorized Official - Phone:574-247-1550
Mailing Address - Street 1:6910 N MAIN STREET
Mailing Address - Street 2:SUITE 12H UNIT 36
Mailing Address - City:GRANGER
Mailing Address - State:IN
Mailing Address - Zip Code:46530-9681
Mailing Address - Country:US
Mailing Address - Phone:574-247-1550
Mailing Address - Fax:574-273-8743
Practice Address - Street 1:6910 N MAIN STREET
Practice Address - Street 2:SUITE 12H UNIT 36
Practice Address - City:GRANGER
Practice Address - State:IN
Practice Address - Zip Code:46530-9681
Practice Address - Country:US
Practice Address - Phone:574-247-1550
Practice Address - Fax:574-273-8743
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2017-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34001654A1041C0700X
IN35000880A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN113501000OtherMAGELLAN ID#
IN000,000,180310OtherBC/BS ID#
IN000,000,180310OtherBC/BS ID#