NPIMap

Organization Active NPI

Growing Minds Learning Center, LLC

Doing business as Surpass Behavioral Health

  • Behavior Analyst
  • Bowling Green, KY
National Provider Identifier
1275813222
Registry record updated Sep 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
GROWING MINDS LEARNING CENTER, LLC
Doing business as
Surpass Behavioral Health
Practice address
1048 Ashley St Ste 101
Bowling Green, KY 42103-2449
Phone
(615) 696-6761
Fax
(615) 880-5782
NPI assigned
Aug 23, 2011
Last updated
Sep 19, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2023

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

Authorized official

Name
Jessica Kirk
Title
Revenue Cycle Manager
Phone
(615) 880-5782

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X
Physical Therapist 225100000X
Occupational Therapist 225X00000X
Speech-Language Pathologist 235Z00000X
Behavior Analyst 103K00000X Primary

Addresses

Primary practice location

1048 Ashley St Ste 101
Bowling Green, KY 42103-2449

Mailing address

PO Box 931142
Atlanta, GA 31193-1142
Phone (615) 696-6761

Other identifiers 2

IdentifierTypeStateIssuer
7100174590OtherKYSCL WAIVER
7100215710MedicaidKY

Other names 1

  • Surpass Behavioral Health Doing business as

National Provider Directory

National Provider Directory

Locations

1040 Market St
Henderson, KY 42420
Phone (270) 635-2601

724 Barret Blvd
#A
Henderson, KY 42420
Phone (270) 827-4652

100 Forbes Dr
Hopkinsville, KY 42240
Phone (270) 215-5945

141 N Eagle Creek Dr
Ste 103
Lexington, KY 40509
Phone (270) 632-6676

1081 Thornberry Dr
Ste C
Madisonville, KY 42431

721 Chuck Gray Ct
Owensboro, KY 42303
Phone (270) 827-4652

3551 Park Plaza Rd
Paducah, KY 42001
Phone (270) 827-4652

30 Medpark Square Dr
Ste 3
Somerset, KY 42503

1321 Murfreesboro Pike
Ste 410
Nashville, TN 37217

Practitioners & affiliated clinicians

Practitioners 125

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.

View all 125

NPI Registry JSON

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

{
    "created_epoch": "1314057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695081600000",
    "number": "1275813222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 931142",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "311931142",
            "telephone_number": "615-696-6761",
            "fax_number": "615-880-5782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1048 ASHLEY ST STE 101",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421032449",
            "telephone_number": "615-696-6761",
            "fax_number": "615-880-5782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GROWING MINDS LEARNING CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-23",
        "last_updated": "2023-09-19",
        "certification_date": "2023-09-19",
        "status": "A",
        "authorized_official_last_name": "KIRK",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "REVENUE CYCLE MANAGER",
        "authorized_official_telephone_number": "615-880-5782"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SCL WAIVER",
            "identifier": "7100174590",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100215710",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Surpass Behavioral Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bowling Green, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2023; 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.