Grow and Transform Licensed Clinical Social Worker Inc

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

GROW AND TRANSFORM LICENSED CLINICAL SOCIAL WORKER INC

Practice address

27120 Eucalyptus Ave Unit G435
Moreno Valley, CA 92555-4543

Phone

(901) 341-4769

Fax

(773) 675-8661

NPI assigned

Feb 11, 2022

Organization subpart

No

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

Authorized official

Name

Teresa Teacher, LCSW

Title

Owner

Phone

(773) 617-0566

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1644537600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644537600000",
    "number": "1699429217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27120 EUCALYPTUS AVE UNIT G435",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925554543",
            "telephone_number": "901-341-4769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27120 EUCALYPTUS AVE UNIT G435",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925554543",
            "telephone_number": "901-341-4769",
            "fax_number": "773-675-8661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GROW AND TRANSFORM LICENSED CLINICAL SOCIAL WORKER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-11",
        "last_updated": "2022-02-11",
        "certification_date": "2022-02-11",
        "status": "A",
        "authorized_official_last_name": "TEACHER",
        "authorized_official_first_name": "TERESA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-617-0566",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Glyniss Claudette Green, PT, DPT, OCS
• Gyssell Green
• Jonathan Greer, M.D.
• Nicole Kathleen Grenier
• Whitney Groeger
• Growth Mindset
• Madison Guandique
• Caroline Guantai, RN
• Joseph Gabriel Gudino
• Raeanne Clemens Guerra, PA-C

• Clinical Social Worker in Moreno Valley, CA
• Providers in Moreno Valley, CA by specialty
• Clinical Social Worker in California

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