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General NPI Number Information
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NPI Number | 1073187092
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Entity Type | Organization
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Legal Business Name | GROWING ROOTS COUNSELING, LLC
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Dates
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Enumeration Date | 05/14/2021
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Last Update Date | 05/14/2021
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Provider Practice Location Address
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Address Line | 529 SEVEN BRIDGE RD UNIT 123
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City | EAST STROUDSBURG
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State | PA
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Zip | 18301-7608
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Country | US
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Telephone | 484-548-0364
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Fax |
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Provider Business Mailing Address
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Address Line | 855 KEENE WAY
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City | SCIOTA
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State | PA
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Zip | 18354-7756
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | THERAPIST/OWNER
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Name | HANNAH COLLETT
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Credential | LPC
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Telephone | 908-763-0319
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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