Provider Demographics
NPI:1972938967
Name:GROWTH & RECOVERY COUNSELING CENTER LLC
Entity Type:Organization
Organization Name:GROWTH & RECOVERY COUNSELING CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, SENIOR THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOY
Authorized Official - Middle Name:DAVIS
Authorized Official - Last Name:VINCENT
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:727-267-6247
Mailing Address - Street 1:7747 MITCHELL BLVD
Mailing Address - Street 2:STE. B
Mailing Address - City:TRINITY
Mailing Address - State:FL
Mailing Address - Zip Code:34655-4725
Mailing Address - Country:US
Mailing Address - Phone:727-267-6247
Mailing Address - Fax:888-878-0546
Practice Address - Street 1:7747 MITCHELL BLVD
Practice Address - Street 2:STE. B
Practice Address - City:TRINITY
Practice Address - State:FL
Practice Address - Zip Code:34655-4725
Practice Address - Country:US
Practice Address - Phone:727-267-6247
Practice Address - Fax:888-878-0546
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-09
Last Update Date:2013-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW95621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty