Personal Growth Concepts, Inc.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

PERSONAL GROWTH CONCEPTS, INC.

Practice address

1825 Barnum Ave
Suite 304
Stratford, CT 06614-5333

Phone

(203) 375-5782

Fax

(203) 375-3048

NPI assigned

Jul 11, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. John A Pacheco, LCSW, LADCNPI 1073531133

Title

President/Director

Phone

(203) 375-5782

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Locations

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• John A Pacheco, LCSW, LADC

  • Clinical Social Worker
  • Stratford, CT
  • NPI 1073531133
  Medicare reassignment NPD Authorized official
• Charles James Mead, LPCA

  • Professional Counselor
  • Stratford, CT
  • NPI 1134751704
  NPD
• Charles Edmund Rodriguez

  • Counselor
  • Stratford, CT
  • NPI 1912692070
  NPD
• Arden Church, LCSW

  • Clinical Social Worker
  • Norwalk, CT
  • NPI 1245716109
  NPD (past)
• Jennifer Lynn Hrbek, MSW, LCSW

  • Clinical Social Worker
  • Westport, CT
  • NPI 1245761154
  NPD (past)
• Janice M Mahieu, LCSW

  • Clinical Social Worker
  • Stratford, CT
  • NPI 1003963620
  NPD (past)
• Lisa V Tucker

  • Social Worker
  • Stratford, CT
  • NPI 1245609205
  NPD (past)
• Marissa M Smith, MD

  • Pediatrics Physician
  • Syracuse, NY
  • NPI 1427218833
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485475200000",
    "number": "1104850353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2505 MAIN ST STE 231",
            "address_2": "SUITE 304",
            "city": "STRATFORD",
            "state": "CT",
            "postal_code": "066155839",
            "telephone_number": "203-375-5782",
            "fax_number": "203-375-3048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1825 BARNUM AVE",
            "address_2": "SUITE 304",
            "city": "STRATFORD",
            "state": "CT",
            "postal_code": "066145333",
            "telephone_number": "203-375-5782",
            "fax_number": "203-375-3048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERSONAL GROWTH CONCEPTS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-11",
        "last_updated": "2017-01-27",
        "status": "A",
        "authorized_official_last_name": "PACHECO",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT/DIRECTOR",
        "authorized_official_telephone_number": "203-375-5782",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW, LADC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leonardo Pena-Abosaid, D.D.S.
• Kristi Alexis Pena, OTR/L
• Penta Dental LC
• Diolenny Perez, LPN
• Daniel Perillo
• Andrew J Pesale, DC
• Robert Pesale, D.C.
• Lauren Pessin, BCBA
• Monique Tyshae Pettway
• Merline Phidd

• Clinical Social Worker in Stratford, CT
• Providers in Stratford, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.