Provider Demographics
NPI:1295431708
Name:GROWTH MINDSET COUNSELING, PLLC
Entity type:Organization
Organization Name:GROWTH MINDSET COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:CHICOSKI
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:269-303-2299
Mailing Address - Street 1:3230 LITES END CT
Mailing Address - Street 2:
Mailing Address - City:PORTAGE
Mailing Address - State:MI
Mailing Address - Zip Code:49024-2381
Mailing Address - Country:US
Mailing Address - Phone:269-873-7617
Mailing Address - Fax:
Practice Address - Street 1:526 W CENTRE AVE
Practice Address - Street 2:
Practice Address - City:PORTAGE
Practice Address - State:MI
Practice Address - Zip Code:49024-5306
Practice Address - Country:US
Practice Address - Phone:269-303-2299
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-06
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty