Healthcare Provider Details

I. General information

NPI: 1477491397
Provider Name (Legal Business Name): GROW & HEAL THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2026
Last Update Date: 03/23/2026
Certification Date: 03/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 MAINE ST STE 500
QUINCY IL
62301-3948
US

IV. Provider business mailing address

510 MAINE ST STE 500
QUINCY IL
62301-3948
US

V. Phone/Fax

Practice location:
  • Phone: 217-231-6362
  • Fax: 217-291-6108
Mailing address:
  • Phone: 217-231-6362
  • Fax: 217-291-6108

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: BECKY ALLEN
Title or Position: THERAPIST/OWNER
Credential: MSED, LCPC
Phone: 217-231-6362