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NPI Code Detail

MEDICARE: GROWTH WELLNESS LLC

MEDICARE: GROWTH WELLNESS LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker

General Provider Information

NPI Number : 1235081001
Entity Type Code : Organization
Provider Name (Legal Business Name) : GROWTH WELLNESS LLC
Provider Business Mailing Address
First Line : 514 MILLBURN AVE UNIT 1154
Second Line :
City : SHORT HILLS
State : NJ
Zip : 07078-2508
Country : US
Telephone Number : 443-274-5611
Fax Number :
Provider Business Practice Location Address
First Line : 514 MILLBURN AVE UNIT 1154
Second Line :
City : SHORT HILLS
State : NJ
Zip : 07078-2508
Country : US
Telephone Number : 443-274-5611
Fax Number :
Authorized Official
Title or Position : FOUNDER, PSYCHOTHERAPIST
Name : MRS. GABRIELLE TAYLOR GROSS
Credential : LCSW, LCSW-C
Telephone Number : 443-274-5611
Provider Enumeration Date : 02/12/2026
Last Update Date : 02/12/2026

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