Healthcare Provider Details

I. General information

NPI: 1467306472
Provider Name (Legal Business Name): BIANCA GROVER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/25/2026
Last Update Date: 02/25/2026
Certification Date: 02/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 S LIBERTY DR STE A
BLOOMINGTON IN
47403-5147
US

IV. Provider business mailing address

3724 W MAPLE LEAF DR
BLOOMINGTON IN
47403-3139
US

V. Phone/Fax

Practice location:
  • Phone: 812-884-1634
  • Fax:
Mailing address:
  • Phone: 219-576-4580
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: