=====================================================
General NPI Number Information
=====================================================
NPI Number | 1538055371
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RIBBON OF GROWTH THERAPY LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/17/2025
-----------------------------------------------------
Last Update Date | 12/15/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3322 MEMORIAL PKWY SW STE 624F
-----------------------------------------------------
City | HUNTSVILLE
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 35801-5348
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 256-519-1708
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 214 NELLIE FAYE LN
-----------------------------------------------------
City | MERIDIANVILLE
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 35759-2810
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 256-519-1708
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | LAKEASHA SHANELL FORD
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 256-519-1708
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------