Provider Demographics
NPI:1750429601
Name:GROWTH RESOURCES, LLC
Entity type:Organization
Organization Name:GROWTH RESOURCES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, GROWTH RESOURCES
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:RUSSELL
Authorized Official - Last Name:ZOBEL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:757-408-1453
Mailing Address - Street 1:4413 WAKEFIELD DR
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23455-4459
Mailing Address - Country:US
Mailing Address - Phone:757-408-1453
Mailing Address - Fax:757-460-5454
Practice Address - Street 1:4413 WAKEFIELD DR
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23455-4459
Practice Address - Country:US
Practice Address - Phone:757-408-1453
Practice Address - Fax:757-460-5454
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040018481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA228769OtherANTHEM BCBS