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General NPI Number Information
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NPI Number | 1871118117
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Entity Type | Organization
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Legal Business Name | NEW GROWTH THERAPY LLC
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Dates
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Enumeration Date | 06/12/2020
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Last Update Date | 09/13/2023
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Provider Practice Location Address
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Address Line | 491 W SPRING STREET
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City | NEDERLAND
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State | CO
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Zip | 80466
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Country | US
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Telephone | 720-282-1727
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Fax | 866-757-5778
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Provider Business Mailing Address
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Address Line | 350 EAST STREET #56
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City | NEDERLAND
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State | CO
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Zip | 80466-0056
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Country | US
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Telephone | 720-282-1727
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Fax | 866-757-5778
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Authorized Official
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Title or Position | OWNER/MBR
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Name | CAMILLA F DYE
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Credential | LPC
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Telephone | 720-282-1727
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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