Healthcare Provider Details

I. General information

NPI: 1780540740
Provider Name (Legal Business Name): GROW THROUGH IT MENTAL HEALTH & WELLNESS CO., LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/02/2026
Last Update Date: 01/02/2026
Certification Date: 01/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 MAIN ST APT 1502
YONKERS NY
10701-2973
US

IV. Provider business mailing address

45 MAIN ST APT 1502
YONKERS NY
10701-2973
US

V. Phone/Fax

Practice location:
  • Phone: 347-236-2042
  • Fax:
Mailing address:
  • Phone: 347-236-2042
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MS. LATISH SHANTEL BANKS
Title or Position: OWNER/COUNSELOR
Credential: MHC-LP
Phone: 347-236-2042