Provider Demographics
NPI:1215669106
Name:INNER GROWTH THERAPY LLC
Entity type:Organization
Organization Name:INNER GROWTH THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MINELIA
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ-ORTIZ
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:857-492-4229
Mailing Address - Street 1:28 CHURCH STREET
Mailing Address - Street 2:SUITE 14 # 915
Mailing Address - City:WINCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01890-2538
Mailing Address - Country:US
Mailing Address - Phone:617-681-4999
Mailing Address - Fax:
Practice Address - Street 1:1 CENTRE STREET TER APT 1A
Practice Address - Street 2:
Practice Address - City:ROXBURY
Practice Address - State:MA
Practice Address - Zip Code:02119-1488
Practice Address - Country:US
Practice Address - Phone:857-492-4229
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-29
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty