Provider Demographics
NPI:1548086689
Name:THE GROWTH GROUP
Entity type:Organization
Organization Name:THE GROWTH GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:BAKKER
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:724-261-7703
Mailing Address - Street 1:12425 WATERSIDE CT
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:MN
Mailing Address - Zip Code:55374-3300
Mailing Address - Country:US
Mailing Address - Phone:724-261-7703
Mailing Address - Fax:
Practice Address - Street 1:13784 83RD WAY N STE 200
Practice Address - Street 2:
Practice Address - City:MAPLE GROVE
Practice Address - State:MN
Practice Address - Zip Code:55369-7207
Practice Address - Country:US
Practice Address - Phone:724-261-7703
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-22
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty