Healthcare Provider Details

I. General information

NPI: 1508738121
Provider Name (Legal Business Name): GROUND & GROWTH PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2025
Last Update Date: 04/25/2026
Certification Date: 04/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

185 DEVONSHIRE ST STE 501
BOSTON MA
02110-1415
US

IV. Provider business mailing address

185 DEVONSHIRE ST STE 501
BOSTON MA
02110-1415
US

V. Phone/Fax

Practice location:
  • Phone: 617-681-8107
  • Fax: 781-494-5696
Mailing address:
  • Phone: 617-681-8107
  • Fax: 781-494-5696

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: STEPHANIE ETIENNE
Title or Position: PMHNP-BC
Credential: NP
Phone: 617-681-8107