Provider Demographics
NPI:1295517381
Name:SPROUT & GROW BEHAVIORAL HEALTH, LLC
Entity type:Organization
Organization Name:SPROUT & GROW BEHAVIORAL HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KASSANDRA
Authorized Official - Middle Name:LEIGH
Authorized Official - Last Name:RISSE
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:214-300-8166
Mailing Address - Street 1:843 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:TELL CITY
Mailing Address - State:IN
Mailing Address - Zip Code:47586-2105
Mailing Address - Country:US
Mailing Address - Phone:812-772-2351
Mailing Address - Fax:812-772-2571
Practice Address - Street 1:843 MAIN ST
Practice Address - Street 2:
Practice Address - City:TELL CITY
Practice Address - State:IN
Practice Address - Zip Code:47586-2105
Practice Address - Country:US
Practice Address - Phone:812-772-2351
Practice Address - Fax:812-772-2571
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-16
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health