Active NPI
Growth Wellness Services LCSW, PLLC
- Mental Health Counselor
- Tarrytown, NY
National Provider Identifier
1760156814
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Legal business name
- GROWTH WELLNESS SERVICES LCSW, PLLC
- Practice address
- 54 Main St Ste 201
Tarrytown, NY 10591-3660 - Phone
- (914) 595-6682
- Fax
- (914) 595-4236
- NPI assigned
- Aug 3, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Toyae Liverpool, LCSW
- Title
- Executive Director/Founder
- Phone
- (914) 595-6682
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
54 Main St Ste 201
Tarrytown, NY 10591-3660
Mailing address
54 Main St Ste 201
Tarrytown, NY 10591-3660
Phone (914) 595-6682
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 06568827 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210827001441 | NY | Part B Supplier - Clinic/Group Practice | 6103221288 | Practice locations: Tarrytown, NY |
National Provider Directory
National Provider DirectoryLocations
54 Main St
Ste 201
Tarrytown, NY 10591
Phone (914) 335-3414
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Mental Health Counselor
- Tarrytown, NY
- NPI 1316586837
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1627948800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1665446400000",
"number": "1760156814",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "54 MAIN ST STE 201",
"city": "TARRYTOWN",
"state": "NY",
"postal_code": "105913660",
"telephone_number": "914-595-6682"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "54 MAIN ST STE 201",
"city": "TARRYTOWN",
"state": "NY",
"postal_code": "105913660",
"telephone_number": "914-595-6682",
"fax_number": "914-595-4236"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GROWTH WELLNESS SERVICES LCSW, PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2021-08-03",
"last_updated": "2022-10-11",
"certification_date": "2022-10-11",
"status": "A",
"authorized_official_last_name": "LIVERPOOL",
"authorized_official_first_name": "TOYAE",
"authorized_official_title_or_position": "EXECUTIVE DIRECTOR/FOUNDER",
"authorized_official_telephone_number": "914-595-6682",
"authorized_official_name_prefix": "Ms.",
"authorized_official_credential": "LCSW"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "06568827",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Tarrytown, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2022; 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.