| Growth Wellness Services Lcsw, Pllc | |
|
54 Main St Ste 201 Tarrytown NY 10591-3660 | |
| (914) 595-6682 | |
| (914) 595-4236 |
| Full Name | Growth Wellness Services Lcsw, Pllc |
|---|---|
| Speciality | Counselor |
| Location | 54 Main St Ste 201, Tarrytown, New York |
| Authorized Official Name and Position | Toyae Liverpool (EXECUTIVE DIRECTOR/FOUNDER) |
| Authorized Official Contact | 9145956682 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Growth Wellness Services Lcsw, Pllc 54 Main St Ste 201 Tarrytown NY 10591-3660 Ph: (914) 595-6682 | Growth Wellness Services Lcsw, Pllc 54 Main St Ste 201 Tarrytown NY 10591-3660 Ph: (914) 595-6682 |
| NPI Number | 1760156814 |
|---|---|
| Provider Enumeration Date | 08/03/2021 |
| Last Update Date | 10/11/2022 |
| Certification Date | 10/11/2022 |
| Medicare PECOS PAC ID | 6103221288 |
|---|---|
| Medicare Enrollment ID | O20210827001441 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760156814 | NPI | - | NPPES |
| 06568827 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Toyae Liverpool |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790193837 PECOS PAC ID: 7810323862 Enrollment ID: I20200211000665 |
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