Healthcare Provider Details

I. General information

NPI: 1891667002
Provider Name (Legal Business Name): CENTER FOR GROWTH AND CONNECTION, A PROFESSIONAL CLINICAL COUNSELOR CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2025
Last Update Date: 09/18/2025
Certification Date: 09/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 E COLORADO BLVD STE 860
PASADENA CA
91101-6151
US

IV. Provider business mailing address

301 E COLORADO BLVD STE 860
PASADENA CA
91101-6151
US

V. Phone/Fax

Practice location:
  • Phone: 626-609-2580
  • Fax:
Mailing address:
  • Phone: 626-609-2580
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MS. MICHELLE D CANTRELL
Title or Position: PRESIDENT
Credential: LPCC
Phone: 626-609-2580