Healthcare Provider Details

I. General information

NPI: 1295653160
Provider Name (Legal Business Name): JOSIAH AUGUST GROVES
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7320 S YALE AVE STE B
TULSA OK
74136-7034
US

IV. Provider business mailing address

8429 E 81ST ST APT 920
TULSA OK
74133-8042
US

V. Phone/Fax

Practice location:
  • Phone: 918-992-2335
  • Fax:
Mailing address:
  • Phone: 918-527-7549
  • 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:
Title or Position:
Credential:
Phone: