MEDICARE: MRS. LALONNIE MARIE GROVES MA, LPC, NCC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	2002012511	MO

General Provider Information

NPI Number	:	1346231743
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LALONNIE MARIE GROVES MA, LPC, NCC

Provider Business Mailing Address
First Line	:	16208 MISSOURI HIGHWAY 13
Second Line	:
City	:	BRANSON WEST
State	:	MO
Zip	:	65737
Country	:	US
Telephone Number	:	417-860-4064
Fax Number	:

Provider Business Practice Location Address
First Line	:	16208 MISSOURI HIGHWAY 13
Second Line	:
City	:	BRANSON WEST
State	:	MO
Zip	:	65737
Country	:	US
Telephone Number	:	417-860-4064
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/03/2005
Last Update Date	:	07/09/2007

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