Healthcare Provider Details

I. General information

NPI: 1750848032
Provider Name (Legal Business Name): GROW COUNSELING INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2019
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

705 E LAHARPE ST STE C
KIRKSVILLE MO
63501-4526
US

IV. Provider business mailing address

PO BOX 924
KIRKSVILLE MO
63501-0924
US

V. Phone/Fax

Practice location:
  • Phone: 660-988-9669
  • Fax: 660-280-2965
Mailing address:
  • Phone: 660-988-9669
  • Fax: 888-414-6717

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name: JONI BENNETT
Title or Position: PRESIDENT
Credential: LPC
Phone: 660-988-9669