NPIMap

Organization Active NPI

Room to Grow: Therapy, Supervision, Consultation, PLLC

  • Marriage & Family Therapist
  • Childress, TX
National Provider Identifier
1124526678
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
201547 Issued in TX
Legal business name
ROOM TO GROW: THERAPY, SUPERVISION, CONSULTATION, PLLC
Practice address
8150 US Highway 287
Childress, TX 79201-7152
Phone
(940) 536-3644
NPI assigned
Jan 30, 2018
Last updated
Mar 17, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Authorized official

Name
Dr. Mary Sue Green, PH.D., LMFTNPI 1689818411
Title
President
Phone
(940) 536-3644

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 106H00000X 201547 TX Primary

Addresses

Primary practice location

8150 US Highway 287
Childress, TX 79201-7152

Mailing address

804 Combs St
Quanah, TX 79252-4444

Other practice location 1

510 King St
Quanah, TX 79252-4841
Phone (940) 536-3644

National Provider Directory

National Provider Directory

Locations

510 King St
Quanah, TX 79252
Phone (940) 536-3644

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1517270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1124526678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 COMBS ST",
            "city": "QUANAH",
            "state": "TX",
            "postal_code": "792524444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8150 US HIGHWAY 287",
            "city": "CHILDRESS",
            "state": "TX",
            "postal_code": "792017152",
            "telephone_number": "940-536-3644"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "510 King St",
            "address_purpose": "LOCATION",
            "city": "Quanah",
            "state": "TX",
            "postal_code": "792524841",
            "country_code": "US",
            "telephone_number": "940-536-3644",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ROOM TO GROW: THERAPY, SUPERVISION, CONSULTATION, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-30",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "940-536-3644",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D., LMFT"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "TX",
            "license": "201547",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Childress, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.