Provider Demographics
NPI:1356051775
Name:GROWTH AND TRANSITIONS MENTAL HEALTH COUNSELING AND CONSULTATION
Entity type:Organization
Organization Name:GROWTH AND TRANSITIONS MENTAL HEALTH COUNSELING AND CONSULTATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:MCCUBBIN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, LAC
Authorized Official - Phone:720-329-3854
Mailing Address - Street 1:3763 IMPERIAL ST UNIT B
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:CO
Mailing Address - Zip Code:80516-9409
Mailing Address - Country:US
Mailing Address - Phone:719-924-5549
Mailing Address - Fax:
Practice Address - Street 1:3763 IMPERIAL ST UNIT B
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:CO
Practice Address - Zip Code:80516-9409
Practice Address - Country:US
Practice Address - Phone:719-924-5499
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CK COUNSELING SERVICES LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-11-28
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)