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Organization
PURE HEALTH AND WELLNESS TREATMENT CENTER, PLLC
Active
Organization
PURE HEALTH AND WELLNESS TREATMENT CENTER, PLLC
Active
Other names
Grow Therapeutic Services, PLLC
Organization subpart
No
Provider details
NPI number
Authorized official
CEYONNA LEWIS LPC (PROGRAM DIRECTOR)
(443) 842-4952
Entity
Organization
Contact information
Practice address
1320 CENTRAL PARK BLVD STE 200, FREDERICKSBURG, VA 22401-4953
(703) 881-6233
Mailing address
1320 CENTRAL PARK BLVD STE 200, FREDERICKSBURG, VA 22401-4953
(703) 881-6233
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
106H00000X
Marriage & Family Therapist
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
12/07/2020
Last updated
01/08/2024
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