=====================================================
General NPI Number Information
=====================================================
NPI Number | 1346547486
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | GROWTH SOLUTIONS COUNSELING
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/25/2011
-----------------------------------------------------
Last Update Date | 02/25/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2006 WALNUT ST SECOND FLOOR
-----------------------------------------------------
City | PHILADELPHIA
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19103-5680
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 610-745-9571
-----------------------------------------------------
Fax | 215-627-3202
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2006 WALNUT ST SECOND FLOOR
-----------------------------------------------------
City | PHILADELPHIA
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19103-5680
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 610-745-9571
-----------------------------------------------------
Fax | 215-627-3202
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | FOUNDER/ THERAPIST
-----------------------------------------------------
Name | MS. RUTH N FEINBLUM
-----------------------------------------------------
Credential | LCSW
-----------------------------------------------------
Telephone | 610-745-9571
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | CW015600
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------