| Grow Well Cleveland, Llc. | |
|
3000 Bridge Ave Ste 4 Cleveland OH 44113-3086 | |
| (216) 282-3838 | |
| Not Available |
| Full Name | Grow Well Cleveland, Llc. |
|---|---|
| Speciality | Counselor |
| Location | 3000 Bridge Ave Ste 4, Cleveland, Ohio |
| Authorized Official Name and Position | Jessica D Sen (DIRECTOR) |
| Authorized Official Contact | 2162823838 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Grow Well Cleveland, Llc. 3000 Bridge Ave Ste 4 Cleveland OH 44113-3086 Ph: () - | Grow Well Cleveland, Llc. 3000 Bridge Ave Ste 4 Cleveland OH 44113-3086 Ph: (216) 282-3838 |
| NPI Number | 1295244317 |
|---|---|
| Provider Enumeration Date | 09/20/2017 |
| Last Update Date | 01/17/2020 |
| Certification Date | 01/17/2020 |
| Medicare PECOS PAC ID | 6305181983 |
|---|---|
| Medicare Enrollment ID | O20181231001624 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295244317 | NPI | - | NPPES |
| 0257790 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| 102L00000X | Psychoanalyst | (* (Not Available)) | Secondary |
| Provider Name | Allison Leann Borstad |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497150809 PECOS PAC ID: 7517386477 Enrollment ID: I20200928001127 |
| Provider Name | Duncan Charles Simpson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346734456 PECOS PAC ID: 6002213667 Enrollment ID: I20210923002532 |
| Provider Name | Carolyn S Allen |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1932694619 PECOS PAC ID: 6002267028 Enrollment ID: I20240103004367 |
| Provider Name | Peter Sylvester Finnerty |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1336417625 PECOS PAC ID: 9638445273 Enrollment ID: I20240202003446 |
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