Healthcare Provider Details

I. General information

NPI: 1265347553
Provider Name (Legal Business Name): SARAGROVE COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10571 E REMICK RD
SAINT LOUIS MI
48880-9509
US

IV. Provider business mailing address

10571 E REMICK RD
SAINT LOUIS MI
48880-9509
US

V. Phone/Fax

Practice location:
  • Phone: 989-944-1289
  • Fax:
Mailing address:
  • Phone: 989-944-1289
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: SARA SHATTUCK
Title or Position: COUNSELOR
Credential: LLPC
Phone: 989-944-1289