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General NPI Number Information
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NPI Number | 1942175526
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Entity Type | Organization
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Legal Business Name | GUIDED GROWTH ABA CONSULTING AND THERAPY
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Dates
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Enumeration Date | 10/06/2025
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Last Update Date | 10/06/2025
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Provider Practice Location Address
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Address Line | 4605 PEMBROKE LAKE CIR STE 102
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City | VIRGINIA BEACH
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State | VA
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Zip | 23455-6435
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Country | US
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Telephone | 757-918-9481
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 68685
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City | VIRGINIA BEACH
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State | VA
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Zip | 23471-8685
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Country | US
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Telephone | 757-918-9481
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Fax |
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | LAKISHA JOHNSON
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Credential | LPC
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Telephone | 757-918-9481
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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