Organization Active NPI

Growing Branches LLC

  • Marriage & Family Therapist
  • Orlando, FL
National Provider Identifier
1538913082
Registry record updated Apr 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Legal business name
GROWING BRANCHES LLC
Practice address
7345 W Sand Lake Rd Ste 303
Orlando, FL 32819-5205
Phone
(407) 488-9043
NPI assigned
Apr 12, 2024
Last updated
Apr 12, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2024

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

Authorized official

Name
Amy Wagner, LMHC LMFTNPI 1568989697
Title
Owner
Phone
(407) 488-9043

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU
Marriage & Family Therapist 106H00000X NU Primary

Addresses

Primary practice location

7345 W Sand Lake Rd Ste 303
Orlando, FL 32819-5205

Mailing address

12190 Canyon Sun TRL
Windermere, FL 34786-6537
Phone (407) 488-9043

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250814004641 FL Part B Supplier - Clinic/Group Practice 8022517382 Receives reassigned benefits from 3 practitioners
Practice locations: Orlando, FL

National Provider Directory

National Provider Directory

Locations

7345 W Sand Lake Rd
Ste 303
Orlando, FL 32819
Phone (321) 300-6723

Practitioners & affiliated clinicians

Practitioners 3

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": "1712880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712880000000",
    "number": "1538913082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12190 CANYON SUN TRL",
            "city": "WINDERMERE",
            "state": "FL",
            "postal_code": "347866537",
            "telephone_number": "407-488-9043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7345 W SAND LAKE RD STE 303",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328195205",
            "telephone_number": "407-488-9043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GROWING BRANCHES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-12",
        "last_updated": "2024-04-12",
        "certification_date": "2024-04-12",
        "status": "A",
        "authorized_official_last_name": "WAGNER",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "407-488-9043",
        "authorized_official_credential": "LMHC  LMFT"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 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.