Provider Demographics
NPI:1922814698
Name:GROWTH THRU CHANGE LLC
Entity type:Organization
Organization Name:GROWTH THRU CHANGE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:STEFANIE
Authorized Official - Middle Name:SOPHIA
Authorized Official - Last Name:BRANDSTETTER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:215-337-3993
Mailing Address - Street 1:1625 SOUTH ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19146-1541
Mailing Address - Country:US
Mailing Address - Phone:215-337-3993
Mailing Address - Fax:215-337-3993
Practice Address - Street 1:1625 SOUTH ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19146-1541
Practice Address - Country:US
Practice Address - Phone:215-337-3993
Practice Address - Fax:215-337-3993
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-09
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health