Provider Demographics
NPI:1144942020
Name:GROWING THROUGH IT THERAPY, PC
Entity type:Organization
Organization Name:GROWING THROUGH IT THERAPY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:SAMANTHA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:MCCULLOUGH
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW-CLINICAL
Authorized Official - Phone:810-955-2093
Mailing Address - Street 1:2169 W VIENNA RD STE 162
Mailing Address - Street 2:
Mailing Address - City:CLIO
Mailing Address - State:MI
Mailing Address - Zip Code:48420-1757
Mailing Address - Country:US
Mailing Address - Phone:810-243-2660
Mailing Address - Fax:810-309-8833
Practice Address - Street 1:6295 N ELMS RD
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:MI
Practice Address - Zip Code:48433-9002
Practice Address - Country:US
Practice Address - Phone:810-955-2093
Practice Address - Fax:810-309-8833
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-16
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty