Healthcare Provider Details

I. General information

NPI: 1245940261
Provider Name (Legal Business Name): GROW THROUGH IT THERAPEUTIC SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2022
Last Update Date: 11/30/2022
Certification Date: 11/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9922 WATERSTONE PL
CORDOVA TN
38016-6648
US

IV. Provider business mailing address

9922 WATERSTONE PL
CORDOVA TN
38016-6648
US

V. Phone/Fax

Practice location:
  • Phone: 901-451-7400
  • Fax:
Mailing address:
  • Phone: 901-451-7400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MS. BRITTANY R PERRY
Title or Position: CLINICAL SOCIAL WORKER
Credential: LCSW
Phone: 901-451-7400