Provider Demographics
NPI:1841591260
Name:GROWING COUNSELING SERVICES, LLC
Entity Type:Organization
Organization Name:GROWING COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TOMANIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:WITHERSPOON
Authorized Official - Suffix:
Authorized Official - Credentials:LLMSW
Authorized Official - Phone:313-995-3702
Mailing Address - Street 1:446 TOBIN DR
Mailing Address - Street 2:311
Mailing Address - City:INKSTER
Mailing Address - State:MI
Mailing Address - Zip Code:48141-3557
Mailing Address - Country:US
Mailing Address - Phone:313-207-9347
Mailing Address - Fax:
Practice Address - Street 1:446 TOBIN DR
Practice Address - Street 2:311
Practice Address - City:INKSTER
Practice Address - State:MI
Practice Address - Zip Code:48141-3557
Practice Address - Country:US
Practice Address - Phone:313-207-9347
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-17
Last Update Date:2010-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801087949273R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit