Provider Demographics
NPI:1811764640
Name:MOMENTUM HEALING AND GROWTH THERAPIES PLLC
Entity type:Organization
Organization Name:MOMENTUM HEALING AND GROWTH THERAPIES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALLISON
Authorized Official - Middle Name:
Authorized Official - Last Name:BENNETT
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:360-201-4019
Mailing Address - Street 1:336 36TH ST
Mailing Address - Street 2:PMB #127
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-6580
Mailing Address - Country:US
Mailing Address - Phone:360-201-4019
Mailing Address - Fax:
Practice Address - Street 1:2 ROSEBUD PL
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98229
Practice Address - Country:US
Practice Address - Phone:360-201-4019
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-12
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty