Healthcare Provider Details

I. General information

NPI: 1851045512
Provider Name (Legal Business Name): GROWTH & SERENITY THROUGH THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/10/2022
Last Update Date: 01/30/2025
Certification Date: 01/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 E MICHIGAN AVE # 143
CLINTON MI
49236-9998
US

IV. Provider business mailing address

123 E MICHIGAN AVE # 143
CLINTON MI
49236-9998
US

V. Phone/Fax

Practice location:
  • Phone: 734-812-9057
  • Fax:
Mailing address:
  • Phone: 734-812-9057
  • Fax:

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: CELIA MARGIT POLICH
Title or Position: CLINICAL SOCIAL WORKER/OWNER
Credential: LMSW
Phone: 734-812-9057