Organization Name: | GROWING POTENTIAL SERVICES:THERAPEUTIC AND BEHAVIORAL SOLUTIONS, PC |
NPI Number: | 1336588607 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MARCY TALICEO (OWNER, PRESIDENT) |
Mailing Address: | 448 Spring St Windsor Locks |
State: | CT US |
Postal Code: | 060961743 |
Phone Number: | 4132653450 |
Fax Number: | |
NPI Enumeration Date: | 06/20/2013 |
NPI Last Update Date: | 07/10/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 8146 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |