Provider Demographics
NPI:1609639152
Name:GROWTH IN ACTION, LLC
Entity Type:Organization
Organization Name:GROWTH IN ACTION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST; CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALYSSA
Authorized Official - Middle Name:
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:781-214-0776
Mailing Address - Street 1:1040 GREAT PLAIN AVE STE 309
Mailing Address - Street 2:
Mailing Address - City:NEEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02492-2565
Mailing Address - Country:US
Mailing Address - Phone:781-214-0776
Mailing Address - Fax:
Practice Address - Street 1:1040 GREAT PLAIN AVE STE 309
Practice Address - Street 2:
Practice Address - City:NEEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02492-2565
Practice Address - Country:US
Practice Address - Phone:781-214-0776
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-06
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty