Provider Demographics
NPI:1851051858
Name:GROWING IN GRACE COUNSELING GROUP
Entity Type:Organization
Organization Name:GROWING IN GRACE COUNSELING GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHARRIEFF
Authorized Official - Middle Name:ALI
Authorized Official - Last Name:BUGG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:862-262-8862
Mailing Address - Street 1:496 E 39TH ST
Mailing Address - Street 2:
Mailing Address - City:PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07504-1408
Mailing Address - Country:US
Mailing Address - Phone:862-262-8862
Mailing Address - Fax:
Practice Address - Street 1:470 CHAMBERLAIN AVE STE 11
Practice Address - Street 2:
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07522-1000
Practice Address - Country:US
Practice Address - Phone:862-262-8826
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-19
Last Update Date:2021-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, EducationGroup - Single Specialty
No405300000XOther Service ProvidersPrevention ProfessionalGroup - Single Specialty