Provider Demographics
NPI:1447842810
Name:GROUNDED GROWTH COUNSELING, PLLC
Entity type:Organization
Organization Name:GROUNDED GROWTH COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:MS
Authorized Official - First Name:ANITA
Authorized Official - Middle Name:RUTH
Authorized Official - Last Name:HARTL
Authorized Official - Suffix:
Authorized Official - Credentials:CSW-PIP
Authorized Official - Phone:605-786-6759
Mailing Address - Street 1:756 EARLEEN ST APT C
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57701-3219
Mailing Address - Country:US
Mailing Address - Phone:605-786-6759
Mailing Address - Fax:
Practice Address - Street 1:405 E OMAHA ST STE D
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57701-2974
Practice Address - Country:US
Practice Address - Phone:605-786-6759
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-08
Last Update Date:2021-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health