Healthcare Provider Details

I. General information

NPI: 1275101560
Provider Name (Legal Business Name): GROW WITH YOUR FLOW COUNSELING, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/14/2021
Last Update Date: 12/03/2021
Certification Date: 12/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 W BRANDON BLVD STE 203
BRANDON FL
33511-5100
US

IV. Provider business mailing address

220 W BRANDON BLVD STE 203
BRANDON FL
33511-5100
US

V. Phone/Fax

Practice location:
  • Phone: 813-464-1007
  • Fax: 813-381-3909
Mailing address:
  • Phone: 813-464-1007
  • Fax: 813-381-3909

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: MARIA REARDON
Title or Position: THERAPIST
Credential: LCSW
Phone: 813-464-1007