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NPI Code Detail

MEDICARE: THE GROWTH CENTER PLLC

MEDICARE: THE GROWTH CENTER PLLC
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
1302F00000XExclusive Provider Organization
2101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1245273507
Entity Type Code : Organization
Provider Name (Legal Business Name) : THE GROWTH CENTER PLLC
Provider Business Mailing Address
First Line : 14502 N DALE MABRY HWY STE 200
Second Line :
City : TAMPA
State : FL
Zip : 33618-2040
Country : US
Telephone Number : 813-517-9944
Fax Number :
Provider Business Practice Location Address
First Line : 14502 N DALE MABRY HWY STE 200
Second Line :
City : TAMPA
State : FL
Zip : 33618-2040
Country : US
Telephone Number : 813-517-9944
Fax Number :
Authorized Official
Title or Position : LICENSED MENTAL HEALTH COUNSELOR
Name : KRISTIN PARKER
Credential :
Telephone Number : 813-517-9944
Provider Enumeration Date : 06/14/2006
Last Update Date : 10/31/2022

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Directions to “THE GROWTH CENTER PLLC ” Practice Location

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