Healthcare Provider Details

I. General information

NPI: 1518053115
Provider Name (Legal Business Name): GROWTH POINTE COUNSELING SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 05/03/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6910 N MAIN STREET SUITE 12H UNIT 36
GRANGER IN
46530-9681
US

IV. Provider business mailing address

6910 N MAIN STREET SUITE 12H UNIT 36
GRANGER IN
46530-9681
US

V. Phone/Fax

Practice location:
  • Phone: 574-247-1550
  • Fax: 574-273-8743
Mailing address:
  • Phone: 574-247-1550
  • Fax: 574-273-8743

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number34001654A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number35000880A
License Number StateIN

VIII. Authorized Official

Name: KAREN MORRIS
Title or Position: OWNER
Credential: LCSW,LMFT
Phone: 574-247-1550