Healthcare Provider Details

I. General information

NPI: 1467100610
Provider Name (Legal Business Name): HOPE & GROWTH COUNSELING NW, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2022
Last Update Date: 07/06/2022
Certification Date: 07/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105B W MAIN STE 113
PUYALLUP WA
98371-5329
US

IV. Provider business mailing address

302 NEW ORLEANS BLVD
MORGANTON NC
28655-2776
US

V. Phone/Fax

Practice location:
  • Phone: 253-205-8362
  • Fax: 828-248-7711
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: RICHARD DONLAVAGE
Title or Position: PARTNER
Credential:
Phone: 828-330-9249