Healthcare Provider Details

I. General information

NPI: 1083562284
Provider Name (Legal Business Name): THE GROUNDED GROVE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2026
Last Update Date: 04/25/2026
Certification Date: 04/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1020 LONG BLVD STE 10A
LANSING MI
48911-6859
US

IV. Provider business mailing address

1418 E MOUNT HOPE AVE
LANSING MI
48910-1831
US

V. Phone/Fax

Practice location:
  • Phone: 919-438-1674
  • Fax:
Mailing address:
  • Phone: 919-438-1674
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: ABIGAIL SMITH
Title or Position: OWNER/PROVIDER
Credential: MSW, LMSW, LISW
Phone: 330-931-5927