Healthcare Provider Details
I. General information
NPI: 1659765758
Provider Name (Legal Business Name): GROWING HEARTS, GROWING MINDS INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/26/2015
Last Update Date: 03/26/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2524 LILLIAN MILLER PKWY SUITE 115
DENTON TX
76210-7206
US
IV. Provider business mailing address
1602 SEQUOIA DR
KRUM TX
76249-7182
US
V. Phone/Fax
- Phone: 940-220-9469
- Fax: 972-426-9609
- Phone: 940-220-9469
- Fax: 972-426-9609
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | 70653 |
| License Number State | TX |
VIII. Authorized Official
Name:
CATHERINE
RICHARDSON
Title or Position: CLINICAL DIRECTOR
Credential: LPC
Phone: 940-220-9469