Provider Demographics
NPI:1730925629
Name:THE LEARNGROW AGENCY
Entity type:Organization
Organization Name:THE LEARNGROW AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:ROSE
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:435-757-1677
Mailing Address - Street 1:75 W 100 S STE 240
Mailing Address - Street 2:
Mailing Address - City:LOGAN
Mailing Address - State:UT
Mailing Address - Zip Code:84321-5842
Mailing Address - Country:US
Mailing Address - Phone:435-757-1677
Mailing Address - Fax:
Practice Address - Street 1:75 W 100 S STE 240
Practice Address - Street 2:
Practice Address - City:LOGAN
Practice Address - State:UT
Practice Address - Zip Code:84321-5842
Practice Address - Country:US
Practice Address - Phone:435-757-1677
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-01
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty