Provider Demographics
NPI:1659021988
Name:ART OF GROWTH COUNSELING SERVICES, PLLC
Entity Type:Organization
Organization Name:ART OF GROWTH COUNSELING SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ORGANIZER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:CROWE
Authorized Official - Suffix:III
Authorized Official - Credentials:MSW, LCSW
Authorized Official - Phone:252-241-0290
Mailing Address - Street 1:3107 EVANS ST STE H
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-7690
Mailing Address - Country:US
Mailing Address - Phone:252-241-0290
Mailing Address - Fax:252-408-6723
Practice Address - Street 1:3107 EVANS ST STE H
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-7690
Practice Address - Country:US
Practice Address - Phone:252-241-0290
Practice Address - Fax:252-408-6723
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-28
Last Update Date:2022-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1760968127Medicaid