MEDICARE: GROWTH SPACE, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1457918526
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GROWTH SPACE, PLLC

Provider Business Mailing Address
First Line	:	8601 N BLACK CANYON HWY STE 103OFC10
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85021-4109
Country	:	US
Telephone Number	:	602-845-0707
Fax Number	:	602-296-0398

Provider Business Practice Location Address
First Line	:	8601 N BLACK CANYON HWY STE 103OFC10
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85021-4109
Country	:	US
Telephone Number	:	602-845-0707
Fax Number	:	602-296-0398

Authorized Official
Title or Position	:	MENTAL HEALTH COUNSELOR/ CLINICIAN
Name	:	KATHRYN MCCLEARN
Credential	:	LPC
Telephone Number	:	602-845-0707

Provider Enumeration Date	:	05/23/2019
Last Update Date	:	12/22/2020

Similar Medicare Providers

1093977092 — SIMCHAH CARE, LLC
Practice Location Address:

8601 N BLACK CANYON HWY , SUITE 208
PHOENIX, AZ
85021-4109

Practice Phone: 602-595-1539
Practice Fax: 602-513-7216

1336706944 — KATHRYN MCCLEARN LPC
Practice Location Address:

8601 N BLACK CANYON HWY STE 103OFC10
PHOENIX, AZ
85021-4109

Practice Phone: 602-845-0707
Practice Fax: 602-296-0398

1104555044 — GOODSIDE HEALTH MEDICAL, PLLC
Practice Location Address:

8601 N BLACK CANYON HWY STE 103-3
PHOENIX, AZ
85021-4109

Practice Phone: 281-203-5006
Practice Fax:

1679416713 — MAILIN PEREZ
Practice Location Address:

1305 W BROWN ST
PHOENIX, AZ
85021-2235

Practice Phone: 602-758-4262
Practice Fax:

1861202335 — UMBRELLA MEDICAL LLC
Practice Location Address:

1728 W GLENDALE AVE STE 100
PHOENIX, AZ
85021-8862

Practice Phone: 623-299-8251
Practice Fax:

1013630458 — JOSHUA RAFAEL RECINOS-ALMANZA
Practice Location Address:

2338 W ROYAL PALM RD STE J
PHOENIX, AZ
85021-9339

Practice Phone: 855-772-8847
Practice Fax:

Directions to “GROWTH SPACE, PLLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.