Provider Demographics
NPI:1629358684
Name:THE BEHAVIORAL GROWING TREE
Entity Type:Organization
Organization Name:THE BEHAVIORAL GROWING TREE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ BEHAVIOR ANALYST
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARICELA
Authorized Official - Middle Name:
Authorized Official - Last Name:ACEVEDO
Authorized Official - Suffix:
Authorized Official - Credentials:MS, BCBA
Authorized Official - Phone:720-421-1710
Mailing Address - Street 1:7200 E DRY CREEK RD STE E104
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-2568
Mailing Address - Country:US
Mailing Address - Phone:866-300-0822
Mailing Address - Fax:303-600-9933
Practice Address - Street 1:7200 E DRY CREEK RD STE E104
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-2568
Practice Address - Country:US
Practice Address - Phone:866-300-0822
Practice Address - Fax:303-600-9933
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-23
Last Update Date:2021-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO46631062Medicaid