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General NPI Number Information
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NPI Number | 1467302711
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Entity Type | Organization
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Legal Business Name | GROWTH PATHWAY THERAPY, PLLC
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Dates
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Enumeration Date | 01/28/2026
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Last Update Date | 01/28/2026
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Provider Practice Location Address
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Address Line | 1006B N BRAGG BLVD # 101
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City | SPRING LAKE
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State | NC
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Zip | 28390-3366
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Country | US
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Telephone | 404-706-6685
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Fax |
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Provider Business Mailing Address
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Address Line | 1006B N BRAGG BLVD # 101
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City | SPRING LAKE
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State | NC
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Zip | 28390-3366
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Country | US
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Telephone | 404-706-6685
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DANIELLE SIBERT
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Credential | MSW, LCSW
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Telephone | 404-706-6685
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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