Provider Demographics
NPI:1164314472
Name:CB GROWTH MINDSET LLC
Entity type:Organization
Organization Name:CB GROWTH MINDSET LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CONOR
Authorized Official - Middle Name:BRYANT
Authorized Official - Last Name:SULLIVAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:240-743-7869
Mailing Address - Street 1:5335 E SHEA BLVD APT 2088
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-5736
Mailing Address - Country:US
Mailing Address - Phone:240-743-7869
Mailing Address - Fax:
Practice Address - Street 1:5335 E SHEA BLVD APT 2088
Practice Address - Street 2:APT 2088
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85254-5736
Practice Address - Country:US
Practice Address - Phone:240-743-7869
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-21
Last Update Date:2025-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty