=====================================================
General NPI Number Information
=====================================================
NPI Number | 1396697116
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MIND GROWTH CLINICAL SERVICES LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/12/2026
-----------------------------------------------------
Last Update Date | 02/12/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1125 NEW BRITAIN AVE
-----------------------------------------------------
City | WEST HARTFORD
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06110-2440
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 860-281-7906
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1125 NEW BRITAIN AVE
-----------------------------------------------------
City | WEST HARTFORD
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06110-2440
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 860-281-7906
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | FOUNDER
-----------------------------------------------------
Name | DARWIN GARCIA-NUNEZ
-----------------------------------------------------
Credential | LCSW
-----------------------------------------------------
Telephone | 860-983-2356
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------