Provider Demographics
NPI:1568864312
Name:GROWCOCK, DAVID (LPC, NCC)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:
Last Name:GROWCOCK
Suffix:
Gender:M
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7911 ARABIAN CV
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78244-3526
Mailing Address - Country:US
Mailing Address - Phone:210-439-9567
Mailing Address - Fax:
Practice Address - Street 1:101 PEACEFUL LN
Practice Address - Street 2:
Practice Address - City:CONVERSE
Practice Address - State:TX
Practice Address - Zip Code:78109-1007
Practice Address - Country:US
Practice Address - Phone:210-248-9077
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-24
Last Update Date:2014-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX69671101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional