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General NPI Number Information
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NPI Number | 1639621600
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Entity Type | Organization
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Legal Business Name | PURPOSEFUL GROWTH, PC
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Dates
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Enumeration Date | 10/26/2016
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Last Update Date | 09/24/2021
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Provider Practice Location Address
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Address Line | 12157 W CEDAR DR STE 200
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City | LAKEWOOD
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State | CO
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Zip | 80228-2105
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Country | US
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Telephone | 720-556-9422
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 140251
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City | EDGEWATER
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State | CO
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Zip | 80214-0251
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SUZANNE NELSON
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Credential |
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Telephone | 720-556-9422
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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 | CSW.00000670
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License Number State | CO
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