Growing Well Family Behavioral Services

Primary specialty

School PsychologistTaxonomy code 103TS0200X

License

SS830 Issued in FL

Legal business name

GROWING WELL FAMILY BEHAVIORAL SERVICES

Practice address

20114 East Pennsylvania Avenue
Dunnellon, FL 34432

Phone

(352) 465-2444

Fax

(352) 465-7854

NPI assigned

Jan 12, 2007

Organization subpart

No

Name

Mary Ann Ellis, EDSNPI 1295042869

Title

School Psychologist

Phone

(352) 465-2444

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

• Mary Ann Ellis, ED.S.

  • School Psychologist
  • Dunnellon, FL
  • NPI 1295042869

  School

  NPD Authorized official

Locations

• Growing Well Family Behavioral Services Doing business as
• Growing Well FBS Other name

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 11, 2020.

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583884800000",
    "number": "1639229362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20114 E PENNSYLVANIA AVE",
            "city": "DUNNELLON",
            "state": "FL",
            "postal_code": "344326033",
            "telephone_number": "352-465-2444",
            "fax_number": "352-465-7854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20114 EAST PENNSYLVANIA AVENUE",
            "city": "DUNNELLON",
            "state": "FL",
            "postal_code": "34432",
            "telephone_number": "352-465-2444",
            "fax_number": "352-465-7854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GROWING WELL FAMILY BEHAVIORAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-12",
        "last_updated": "2020-03-11",
        "certification_date": "2020-03-11",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "SCHOOL PSYCHOLOGIST",
        "authorized_official_telephone_number": "352-465-2444",
        "authorized_official_credential": "EDS"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, School",
            "state": "FL",
            "license": "SS830",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF FL AGENCY FOR PE",
            "identifier": "691219296",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF FL AGENCY FOR PE",
            "identifier": "691219298",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Growing Well Family Behavioral Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Growing Well FBS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Hector Xavier Gonzalez
• Marilyn Gonzalez
• David Gorlin, MD
• Grand Rising Holistic Wellness Center
• Teresa A Grimes
• Kathleen Marie Hahn, PT
• Shanna Hall, RBT
• Tiffany Hammond, APRN
• Hampton Alf at Gardens, LLC
• Hampton Alf at West, LLC

• All providers in Dunnellon, FL
• School Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 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.