Provider Demographics
NPI:1609435932
Name:GROW, ENCOURAGE, EMPOWER PLLC
Entity Type:Organization
Organization Name:GROW, ENCOURAGE, EMPOWER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/FOUNDER
Authorized Official - Prefix:MS
Authorized Official - First Name:GRETCHEN
Authorized Official - Middle Name:AMANDA
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:MA LPC
Authorized Official - Phone:908-463-0571
Mailing Address - Street 1:711 SAMUEL CARY DR
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27511-3299
Mailing Address - Country:US
Mailing Address - Phone:908-463-0571
Mailing Address - Fax:
Practice Address - Street 1:417 KILDAIRE FARM RD
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-3433
Practice Address - Country:US
Practice Address - Phone:919-443-9095
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-11
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty