Healthcare Provider Details

I. General information

NPI: 1538055371
Provider Name (Legal Business Name): RIBBON OF GROWTH THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3322 MEMORIAL PKWY SW STE 624F
HUNTSVILLE AL
35801-5348
US

IV. Provider business mailing address

214 NELLIE FAYE LN
MERIDIANVILLE AL
35759-2810
US

V. Phone/Fax

Practice location:
  • Phone: 256-519-1708
  • Fax:
Mailing address:
  • Phone: 256-519-1708
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: LAKEASHA SHANELL FORD
Title or Position: OWNER
Credential:
Phone: 256-519-1708