Healthcare Provider Details

I. General information

NPI: 1689516528
Provider Name (Legal Business Name): GROUND AND GROW WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/08/2026
Last Update Date: 04/08/2026
Certification Date: 04/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44075 PIPELINE PLZ STE 225
ASHBURN VA
20147-5889
US

IV. Provider business mailing address

304 SHILOH PL SE
LEESBURG VA
20175-4410
US

V. Phone/Fax

Practice location:
  • Phone: 571-267-0737
  • Fax:
Mailing address:
  • Phone: 571-267-0737
  • 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: NIKKI R GREAUX
Title or Position: LICENSED PROFESSIONAL COUNSELOR
Credential: LPC
Phone: 571-267-0737