| Growth Space, Pllc | |
|
8601 N Black Canyon Hwy Ste 103ofc10 Phoenix AZ 85021-4109 | |
| (602) 845-0707 | |
| (602) 296-0398 |
| Full Name | Growth Space, Pllc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 8601 N Black Canyon Hwy Ste 103ofc10, Phoenix, Arizona |
| Authorized Official Name and Position | Kathryn Mcclearn (MENTAL HEALTH COUNSELOR/ CLINICIAN) |
| Authorized Official Contact | 6028450707 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Growth Space, Pllc 8601 N Black Canyon Hwy Ste 103ofc10 Phoenix AZ 85021-4109 Ph: (602) 845-0707 | Growth Space, Pllc 8601 N Black Canyon Hwy Ste 103ofc10 Phoenix AZ 85021-4109 Ph: (602) 845-0707 |
| NPI Number | 1457918526 |
|---|---|
| Provider Enumeration Date | 05/23/2019 |
| Last Update Date | 12/22/2020 |
| Certification Date | 12/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457918526 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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