Provider Demographics
NPI:1669094686
Name:G.R.O.W.T.H. COUNSELING AND THERAPY
Entity type:Organization
Organization Name:G.R.O.W.T.H. COUNSELING AND THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-320-5559
Mailing Address - Street 1:1001 N MIAMI BEACH BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33162-3842
Mailing Address - Country:US
Mailing Address - Phone:786-320-5559
Mailing Address - Fax:786-796-1021
Practice Address - Street 1:1001 N MIAMI BEACH BLVD
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33162-3842
Practice Address - Country:US
Practice Address - Phone:718-785-6367
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-13
Last Update Date:2021-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management