Provider Demographics
NPI:1942050851
Name:GROWING MINDS ASSESSMENT CENTER PLLC
Entity Type:Organization
Organization Name:GROWING MINDS ASSESSMENT CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:MIERAS
Authorized Official - Last Name:PERUGINI
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:480-605-0413
Mailing Address - Street 1:PO BOX 7595
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85246-7595
Mailing Address - Country:US
Mailing Address - Phone:480-605-0413
Mailing Address - Fax:480-916-1686
Practice Address - Street 1:1600 W CHANDLER BLVD STE 260
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-6179
Practice Address - Country:US
Practice Address - Phone:480-605-0413
Practice Address - Fax:480-916-1686
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-25
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty