Provider Demographics
NPI:1831657048
Name:FAITHFULLY GROWING LLC
Entity Type:Organization
Organization Name:FAITHFULLY GROWING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NIA
Authorized Official - Middle Name:DANIELLE
Authorized Official - Last Name:DENARD-WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:203-727-2051
Mailing Address - Street 1:647 CALIFORNIA ST
Mailing Address - Street 2:
Mailing Address - City:STRATFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06614-4908
Mailing Address - Country:US
Mailing Address - Phone:203-727-2051
Mailing Address - Fax:
Practice Address - Street 1:647 CALIFORNIA ST
Practice Address - Street 2:
Practice Address - City:STRATFORD
Practice Address - State:CT
Practice Address - Zip Code:06614-4908
Practice Address - Country:US
Practice Address - Phone:203-727-2051
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-06
Last Update Date:2022-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty