Graceful Growth Clinic LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

GRACEFUL GROWTH CLINIC LLC

Practice address

66 W Vine St Ste 6
Tooele, UT 84074-2185

Phone

(801) 928-8980

NPI assigned

Jun 28, 2024

Organization subpart

No

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

Authorized official

Name

Ms. Miriam Buell, LCMHCNPI 1063995165

Title

Lcmhc/Owner

Phone

(385) 409-0363

Specialties & licenses 1

Addresses

Other names 1

• Graceful Growth Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Locations

Practitioners 2

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

• Miriam Eileen Buell, CMHC

  • Mental Health Counselor
  • Tooele, UT
  • NPI 1063995165
  Medicare reassignment NPD Authorized official
• Kellie Lee Korth

  • Social Worker
  • Tooele, UT
  • NPI 1881514321
  NPD (past)

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

{
    "created_epoch": "1719532800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720569600000",
    "number": "1144065202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "657 E 980 N",
            "city": "TOOELE",
            "state": "UT",
            "postal_code": "840749833",
            "telephone_number": "801-928-8980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66 W VINE ST STE 6",
            "city": "TOOELE",
            "state": "UT",
            "postal_code": "840742185",
            "telephone_number": "801-928-8980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACEFUL GROWTH CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-28",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A",
        "authorized_official_last_name": "BUELL",
        "authorized_official_first_name": "MIRIAM",
        "authorized_official_title_or_position": "LCMHC/OWNER",
        "authorized_official_telephone_number": "385-409-0363",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCMHC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Graceful Growth Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Graceful Growth Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jessica Goodworth
• Carol Jean Gora, MPT
• Brock Gorringe
• Goshute Health Care LLC
• Jim J Gould, M.D.
• Granger Medical Clinic PC
• Makenzie Green
• Patrick Nelson Green, M.D.
• Michael Todd Griffeth, MD
• Denise Groves, CSW

• Mental Health Counselor in Tooele, UT
• Providers in Tooele, UT by specialty
• Mental Health Counselor in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2024; 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.