Healthcare Provider Details
I. General information
NPI: 1205750601
Provider Name (Legal Business Name): INGRID NATALIA GROOVER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 08/07/2026
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1228 8TH ST
GREELEY CO
80631-3216
US
IV. Provider business mailing address
1924 DORSET DR
FORT COLLINS CO
80526-1150
US
V. Phone/Fax
- Phone: 720-663-0233
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | LPC.0018538 |
| License Number State | CO |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YA0400X |
| Taxonomy | Addiction (Substance Use Disorder) Counselor |
| License Number | ACD.0001910 |
| License Number State | CO |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: