Personal Growth Corporation

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW420 Issued in ID

Legal business name

PERSONAL GROWTH CORPORATION

Practice address

211 S Woodruff
Idaho Falls, ID 83401

Phone

(208) 529-5548

Fax

(208) 529-5588

NPI assigned

Jan 31, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Michael Jon Harris, MSW, PHD

Title

Director

Phone

(208) 529-5548

Specialties & licenses 1

Addresses

Other names 1

• Personal Growth Center Other name

Locations

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1286409600000",
    "number": "1255478293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 S WOODRUFF",
            "address_2": "SUITE A4",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "83401",
            "telephone_number": "208-529-5548",
            "fax_number": "208-529-5588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 S WOODRUFF",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "83401",
            "telephone_number": "208-529-5548",
            "fax_number": "208-529-5588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERSONAL GROWTH CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-31",
        "last_updated": "2010-10-07",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "JON",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "208-529-5548",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MSW, PHD"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LCSW420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Personal Growth Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Candice Joann Perry, MS
• Reyna Perry, LSW
• Trae Perry, M.S. CCC - SLP
• Personal Advantage Counseling
• Personal Care Services LLC
• Eric W. Perttula, M.D.
• Lisa Anne Perucca, LMSW
• Kiley Petencin
• Iris Peter, PA-C
• Ryne Shawn Peters, DO

• Clinical Social Worker in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Clinical Social Worker in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2010; 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.