Healthcare Provider Details

I. General information

NPI: 1568307791
Provider Name (Legal Business Name): HEATHER GROSSMAN LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/22/2026
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 S TAFT AVE STE 206
LOVELAND CO
80537-6962
US

IV. Provider business mailing address

1401 S TAFT AVE STE 206
LOVELAND CO
80537-6962
US

V. Phone/Fax

Practice location:
  • Phone: 970-528-1180
  • Fax:
Mailing address:
  • Phone: 970-528-1180
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0024007
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: