Provider Demographics
NPI:1154155273
Name:GLIMMERS & GROWTH COUNSELING COLLECTIVE
Entity type:Organization
Organization Name:GLIMMERS & GROWTH COUNSELING COLLECTIVE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NIKI
Authorized Official - Middle Name:
Authorized Official - Last Name:PICOGNA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-821-1723
Mailing Address - Street 1:1416 HIGHVIEW DR
Mailing Address - Street 2:
Mailing Address - City:LUTHERVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21093-3513
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2213 SW 32ND ST
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33914-4950
Practice Address - Country:US
Practice Address - Phone:941-216-5726
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-30
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty