Organization
GROWTH SPACE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MYRA L HERNANDEZ PHD., LPC-S (FOUNDER/PROVIDER)
(915) 703-1415
Entity
Organization
Contact information
Practice address
5900 BALCONES DR STE 9355, AUSTIN, TX 78731-4257
(915) 703-1415
(915) 235-3201
Mailing address
5900 BALCONES DR STE 9355, AUSTIN, TX 78731-4257
(915) 703-1415
(915) 235-3201
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
029085011
—
TX
01
—
1033322417
TYPE 1 NPI
—
05
—
4714040
—
TX
Enumeration date
05/22/2023
Last updated
01/15/2026
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