Growing a company rooted in helping others

Building a business that’s centered around helping kids reach their full potential can be a challenging, fulfilling, and complicated endeavor. Alternatively, it also offers many life lessons for growth, both personally and professionally.

At the 2025 Inc. 5000 event celebrating some of the fastest-growing private companies in America, we sat down with Avani Shah, CEO, and Sarup Shah, CFO of Therapy Smarts, a pediatric therapy clinic offering services to help children reach and exceed developmental milestones.

Avani and Sarup, who are also husband and wife, discussed how their comprehensive approach to building their business has helped them make a real impact for children and their families. In addition, they also talked about the three of the most valuable pieces of advice they’ve learned along the way.

Therapy Smarts was founded in 2016 as a multidisciplinary medical practice in Durham, NC, offering services across speech, occupational, physical, mental health, and behavioral therapies. As she was starting the business, Avani Shah felt the pressure to tackle everything on her own, essentially wearing all the hats needed to get things done.

“Initially, you are doing everything on your own,” said Avani. “You are the builder...the therapist...the receptionist, you are making all the calls and (you’re not sure) when to hire the help."

Avani’s husband, Sarup Shah, concurred with that sense of overwhelm and pressure to scale the business effectively, saying he wanted to help his wife figure out “how she would benefit from additional leadership assistance...and put the right team around her to be able to make the business work and grow.”

Both Avani and Sarup shared that there have been a few key moments for Therapy Smarts that have been pivotal in creating the robust business they have today, with 224% growth over a three-year period, from 2022–2025.

Said Sarup, “One big moment for us has been expanding to two locations...and feeling the pressure to make sure we have all the right tools and processes in place for our employees and our clientele.”

As the CEO, Avani had a slightly more personal perspective on their pivotal moments, stating that one of the most meaningful parts of their growth has been the growing trust of the parents of the children who come to them for therapy services.

Said Avani, “When kids get out of their car to come to the clinic, the gratitude from the parents that come to us crying, saying how much difference we made in the life of their child, in the life of their families...has been really rewarding...and it excites us to get up every single morning to do what we do.”

When asked what Therapy Smarts is doing to help differentiate their business from similar practices in the Raleigh-Durham area, Avani said that they’ve made real efforts to distinguish themselves across several key areas.

Said Avani, “There are many things that we do differently...one is offering all the services under one roof, which saves the parents the hustle of driving children from one clinic to the other. We also make services easily accessible by being in network with most of the insurance companies.”

Another way that Therapy Smarts stands out is the practice’s support for multilingual populations. Shared Avani, “We serve the diverse population in our community by having bilingual team members to work with them...we're very proud of that.”

For all the business founders we spoke to at the Inc 5000 event, we asked each of them to share three insights they learned along the way that ended up changing their business. Here’s what Avani and Sarup had to share about their journey to building Therapy Smarts:

When asked if there was anything she would have done differently as a business leader, Avani stated that she would try to find more mentors in her field who have been on similar journeys, saying, “If I had to start all over again, one thing that I would do better is building a network of people...who could offer real advice about the dos and don’ts I needed to keep in mind to be successful.”

"Another key business insight for Avani came from Walt Disney, who is quoted as saying that in order for your dreams to come true, you have to have the courage to pursue them."

“And I truly believe that,” Avani stated, adding, “No matter what happens, resilience is one of the things that is very important...If you can go from one failure to the other without losing your motivation, then you can really achieve your dreams.”

As a married couple and business partners in Therapy Smarts, Avani and Sarup have learned not only to lean on each other, but to reach out to others when they need different types of support. 

Sarup stated that learning how to partner with the people around you is critical for success, stating, “Surround yourself with the right team who can tell you how to do things better in areas that you don't understand.”

Finding the right support, Sarup said, not only helps you learn more, but is integral to the growth of any company.

As the CFO for Therapy Smarts, Sarup shared that he and Avani started working with Capital One Business in 2018, as their business was in the early stages of expanding their practice, saying, “Capital One Business has really helped simplify all of our financial processes. We've utilized their business accounts and credit cards...and they have really helped our growth and operations.”

Because Capital One has been able to help Therapy Smarts streamline their financial management, Sarup reported, the business has not only grown in size and profitability, but its new efficiencies have allowed them to better focus on their primary goal: serving their patients.

Said Sarup, “Streamlining our finances with Capital One Business has really helped us from an operational standpoint to be able to keep our focus on our clients.”

Capital One Business is here to support founders like Avani and Sarup on their journey to building success in life and business. How could the right support help as you create your own business story?