Healthcare Provider Details

I. General information

NPI: 1588068787
Provider Name (Legal Business Name): GROWING MINDS PSYCHOLOGICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2014
Last Update Date: 02/05/2025
Certification Date: 02/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16800 DEVONSHIRE ST STE 301
GRANADA HILLS CA
91344-7410
US

IV. Provider business mailing address

16800 DEVONSHIRE ST STE 301
GRANADA HILLS CA
91344-7410
US

V. Phone/Fax

Practice location:
  • Phone: 323-459-4968
  • Fax: 855-380-5459
Mailing address:
  • Phone: 323-459-4968
  • Fax: 855-380-5459

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. SVETLANA RAVINOVICH
Title or Position: PSYCHOLOGIST/OWNER
Credential: PSY.D.
Phone: 323-459-4968