Healthcare Provider Details

I. General information

NPI: 1073431938
Provider Name (Legal Business Name): GROWING MINDS THERAPY CO PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3710 CAMBRIDGE ST
MIDLAND MI
48642-3691
US

IV. Provider business mailing address

3710 CAMBRIDGE ST
MIDLAND MI
48642-3691
US

V. Phone/Fax

Practice location:
  • Phone: 989-640-5188
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: JAMISON CLEAVER
Title or Position: SPEECH-LANGUAGE PATHOLOGIST
Credential: CCC-SLP
Phone: 989-640-5188