Provider Demographics
NPI:1699315614
Name:ASCENSION GROWTH CENTER, PLLC.
Entity type:Organization
Organization Name:ASCENSION GROWTH CENTER, PLLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TASHA
Authorized Official - Middle Name:
Authorized Official - Last Name:HUNTER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:919-344-3669
Mailing Address - Street 1:644 N SPENCE AVE
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27534-4233
Mailing Address - Country:US
Mailing Address - Phone:919-344-3669
Mailing Address - Fax:866-610-4723
Practice Address - Street 1:644 N SPENCE AVE
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27534-4233
Practice Address - Country:US
Practice Address - Phone:919-344-3669
Practice Address - Fax:866-610-4723
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-07
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)