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Organization

EVERGROWING DEVELOPMENT CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LATRICE LEWIS MA, LPC (DIRECTOR)
(215) 776-6555
Entity
Organization

Contact information

Practice address
6703 GERMANTOWN AVE, PHILADELPHIA, PA 19119-2109
(215) 687-7050
Mailing address
PO BOX 4044, PHILADELPHIA, PA 19118-8044

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
101YA0400X
Addiction (Substance Use Disorder) Counselor
103T00000X
Psychologist
2084P0800X
Psychiatry Physician
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist

Other

Enumeration date
05/18/2021
Last updated
05/18/2021
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