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General NPI Number Information
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NPI Number | 1639051949
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Entity Type | Organization
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Legal Business Name | GROWING MINDS PSYCHIATRY
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Dates
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Enumeration Date | 07/25/2025
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Last Update Date | 11/12/2025
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Provider Practice Location Address
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Address Line | 1061 GOLDEN LEDGE LANE
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City | ELGIN
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State | SC
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Zip | 29045-8018
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Country | US
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Telephone | 803-776-1053
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Fax |
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Provider Business Mailing Address
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Address Line | 1061 GOLDEN LEDGE LANE
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City | ELGIN
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State | SC
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Zip | 29045-8018
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Country | US
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Telephone | 803-561-6414
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Fax |
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | DR. NIKKI RACQUEL SMITH
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Credential | DNP, APRN, FNP-BC
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Telephone | 803-561-6414
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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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