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General NPI Number Information
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NPI Number | 1528807583
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Entity Type | Organization
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Legal Business Name | GROWTH ALLIANCE COUNSELING, CONSULTING, AND COACHING, LLC
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Dates
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Enumeration Date | 05/20/2024
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Last Update Date | 05/22/2024
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Provider Practice Location Address
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Address Line | 1605 FAWCETT LN
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City | RICHMOND
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State | VA
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Zip | 23231-5263
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Country | US
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Telephone | 804-569-5944
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Fax |
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Provider Business Mailing Address
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Address Line | 1605 FAWCETT LN
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City | RICHMOND
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State | VA
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Zip | 23231-5263
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Country | US
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Telephone | 804-569-5944
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Fax |
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Authorized Official
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Title or Position | OWNER / THERAPIST
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Name | MRS. JESSICA VERMONT
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Credential | LCSW
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Telephone | 804-569-5944
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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