Organization Active NPI

Freedom to Grow PLLC

  • Clinical Psychologist
  • Royal Oak, MI
National Provider Identifier
1467184374
Registry record updated Jun 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
FREEDOM TO GROW PLLC
Practice address
104 W 4TH St Ste 204
Royal Oak, MI 48067-3803
Phone
(248) 504-2275
NPI assigned
Jun 29, 2022
Last updated
Jun 29, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2022

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

Authorized official

Name
Benjamin Campbell, LLPNPI 1841848587
Title
Owner
Phone
(310) 745-9834

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
Clinical Psychologist 103TC0700X NU Primary

Addresses

Primary practice location

104 W 4TH St Ste 204
Royal Oak, MI 48067-3803

Mailing address

326 E Kenilworth Ave
Royal Oak, MI 48067-3716
Phone (310) 745-9834

National Provider Directory

National Provider Directory

Locations

104 W 4th St
Ste 204
Royal Oak, MI 48067
Phone (248) 504-2275

Practitioners & affiliated clinicians

Practitioners 1

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": "1656460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656460800000",
    "number": "1467184374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "326 E KENILWORTH AVE",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480673716",
            "telephone_number": "310-745-9834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 W 4TH ST STE 204",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480673803",
            "telephone_number": "248-504-2275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREEDOM TO GROW PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-29",
        "last_updated": "2022-06-29",
        "certification_date": "2022-06-29",
        "status": "A",
        "authorized_official_last_name": "CAMPBELL",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-745-9834",
        "authorized_official_credential": "LLP"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Royal Oak, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2022; 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.