Provider Demographics
NPI:1568088094
Name:GROWING MINDS PSYCHOLOGICAL SERVICES, PLLC
Entity Type:Organization
Organization Name:GROWING MINDS PSYCHOLOGICAL SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:PLUE
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:603-210-3070
Mailing Address - Street 1:57 CENTER RD
Mailing Address - Street 2:
Mailing Address - City:CANTERBURY
Mailing Address - State:NH
Mailing Address - Zip Code:03224-2401
Mailing Address - Country:US
Mailing Address - Phone:603-210-3070
Mailing Address - Fax:
Practice Address - Street 1:57 CENTER RD
Practice Address - Street 2:
Practice Address - City:CANTERBURY
Practice Address - State:NH
Practice Address - Zip Code:03224-2401
Practice Address - Country:US
Practice Address - Phone:603-210-3070
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-20
Last Update Date:2020-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)