Healthcare Provider Details

I. General information

NPI: 1871458836
Provider Name (Legal Business Name): EMOTIONAL GROWTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/22/2025
Last Update Date: 12/26/2025
Certification Date: 12/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 N MAIN ST SUITE #100
FRANKLIN VA
23851
US

IV. Provider business mailing address

3523 FRANCIS ST
PETERSBURG VA
23805-9350
US

V. Phone/Fax

Practice location:
  • Phone: 804-926-6392
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: KAREEM THOMAS
Title or Position: OWNER
Credential: QMHP
Phone: 804-926-6392