Provider Demographics
NPI:1598474868
Name:GROUNDED IN GROWTH THERAPY LLC
Entity Type:Organization
Organization Name:GROUNDED IN GROWTH THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:DOMINIQUEA
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTRONOVO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:602-525-7997
Mailing Address - Street 1:806 PHILLIPS LN
Mailing Address - Street 2:
Mailing Address - City:STATESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28625-4596
Mailing Address - Country:US
Mailing Address - Phone:602-525-7997
Mailing Address - Fax:
Practice Address - Street 1:9164 N 95TH LN
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85345-6346
Practice Address - Country:US
Practice Address - Phone:602-525-7997
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-15
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty