Provider Demographics
NPI:1134920739
Name:BRILLIANT GROWTH COUNSELING
Entity type:Organization
Organization Name:BRILLIANT GROWTH COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:IAN
Authorized Official - Last Name:TUMOLO
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:480-227-6440
Mailing Address - Street 1:793 N ALMA SCHOOL RD # D6
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-3681
Mailing Address - Country:US
Mailing Address - Phone:480-227-6440
Mailing Address - Fax:480-566-9645
Practice Address - Street 1:793 N ALMA SCHOOL RD # D6
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-3681
Practice Address - Country:US
Practice Address - Phone:480-227-6440
Practice Address - Fax:480-566-9645
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-20
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty