Provider Demographics
NPI:1881396950
Name:GROWER, PAUL JOSEPH (CASAC-T)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:JOSEPH
Last Name:GROWER
Suffix:
Gender:M
Credentials:CASAC-T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 FRAME ROAD
Mailing Address - Street 2:
Mailing Address - City:BRIARCLIFF MANOR
Mailing Address - State:NY
Mailing Address - Zip Code:10510-1121
Mailing Address - Country:US
Mailing Address - Phone:917-209-4732
Mailing Address - Fax:
Practice Address - Street 1:706 EXECUTIVE BLVD
Practice Address - Street 2:
Practice Address - City:VALLEY COTTAGE
Practice Address - State:NY
Practice Address - Zip Code:10989-2038
Practice Address - Country:US
Practice Address - Phone:845-362-3904
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-21
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)