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General NPI Number Information
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NPI Number | 1174235873
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Entity Type | Organization
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Legal Business Name | GROWTH JOURNEY INC
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Dates
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Enumeration Date | 12/14/2022
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Last Update Date | 05/30/2025
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Provider Practice Location Address
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Address Line | 2201 PENNSYLVANIA AV SUITE 101
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City | PHILADELPHIA
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State | PA
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Zip | 19130
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Country | US
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Telephone | 267-713-8831
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Fax |
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Provider Business Mailing Address
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Address Line | 5114 F ST FL 3
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City | PHILADELPHIA
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State | PA
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Zip | 19124-3027
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Country | US
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Telephone | 267-713-8831
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Fax |
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Authorized Official
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Title or Position | FOUNDER
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Name | NELSERY Y DE LEON
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Credential | LMFT
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Telephone | 646-420-9606
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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