Organization Active NPI

Growth Space, PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Phoenix, AZ
National Provider Identifier
1457918526
Registry record updated Dec 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
GROWTH SPACE, PLLC
Practice address
8601 N Black Canyon Hwy Ste 103Ofc10
Phoenix, AZ 85021-4109
Phone
(602) 845-0707
Fax
(602) 296-0398
NPI assigned
May 23, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2020

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

Authorized official

Name
Kathryn McClearn, LPCNPI 1336706944
Title
Mental Health Counselor/ Clinician
Phone
(602) 845-0707

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
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

8601 N Black Canyon Hwy Ste 103Ofc10
Phoenix, AZ 85021-4109

Mailing address

8601 N Black Canyon Hwy Ste 103Ofc10
Phoenix, AZ 85021-4109
Phone (602) 845-0707

National Provider Directory

National Provider Directory

Locations

8601 N Black Canyon Hwy
Ste 103
Phoenix, AZ 85021
Phone (602) 628-6636

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1558569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1608595200000",
    "number": "1457918526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8601 N BLACK CANYON HWY STE 103OFC10",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850214109",
            "telephone_number": "602-845-0707",
            "fax_number": "602-296-0398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8601 N BLACK CANYON HWY STE 103OFC10",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850214109",
            "telephone_number": "602-845-0707",
            "fax_number": "602-296-0398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GROWTH SPACE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-23",
        "last_updated": "2020-12-22",
        "certification_date": "2020-12-22",
        "status": "A",
        "authorized_official_last_name": "MCCLEARN",
        "authorized_official_first_name": "KATHRYN",
        "authorized_official_title_or_position": "MENTAL HEALTH COUNSELOR/ CLINICIAN",
        "authorized_official_telephone_number": "602-845-0707",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2020; 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.