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A GROWTH PLACE INC. NPI 1073643482


NPI Information

NPI: 1073643482
Provider Name: A GROWTH PLACE, INC.
Classification: Marriage & Family Therapist - 106H00000X
Entity Type: Organization
Address:
10 WILSON RD
SUITE 1
STOCKBRIDGE, GA
ZIP 30281
Phone: (770) 506-9575
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A GROWTH PLACE, INC. is a marriage family therapist in Stockbridge, GA. The provider is a marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups. A GROWTH PLACE, INC. NPI is 1073643482. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

10 WILSON RD
SUITE 1
STOCKBRIDGE, GA
ZIP 30281-433
Phone: (770) 506-9575
Fax: (770) 506-9369

The provider's authorized official is Gregory T. Samples .
The authorized official title is President and has the following contact phone number (770) 506-9575.

The enumeration date for this NPI number is 3/6/2007 and was last updated on 11/30/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1106H00000XMarriage & Family TherapistMFT000125GEORGIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1301563086AMEDICAIDGEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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