Healthcare Provider Details
I. General information
NPI: 1558201962
Provider Name (Legal Business Name): GROWING GAINS OT, PT, SLP PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/30/2026
Last Update Date: 03/30/2026
Certification Date: 03/29/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
94 9TH ST STE 218
BROOKLYN NY
11215-3156
US
IV. Provider business mailing address
160 W 66TH ST APT 19H
NEW YORK NY
10023-6557
US
V. Phone/Fax
- Phone: 718-750-8478
- Fax:
- Phone: 646-655-7434
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225X00000X |
| Taxonomy | Occupational Therapist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CHRISTINE
ELIZABETH
BEAVERS
Title or Position: MANAGING MEMBER
Credential: PT, DPT
Phone: 646-907-9795