Healthcare Provider Details

I. General information

NPI: 1164314472
Provider Name (Legal Business Name): CB GROWTH MINDSET LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2025
Last Update Date: 08/16/2026
Certification Date: 08/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8350 E RAINTREE DR STE 120
SCOTTSDALE AZ
85260-2691
US

IV. Provider business mailing address

8350 E RAINTREE DR STE 120
SCOTTSDALE AZ
85260-2691
US

V. Phone/Fax

Practice location:
  • Phone: 602-361-8865
  • Fax:
Mailing address:
  • Phone: 602-361-8865
  • 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: CONOR BRYANT SULLIVAN
Title or Position: OWNER
Credential: LCSW
Phone: 602-361-8865