Healthcare Provider Details

I. General information

NPI: 1134530561
Provider Name (Legal Business Name): SPRING GROVE COUNSELING, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2014
Last Update Date: 05/28/2024
Certification Date: 05/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8104 SPRING CYPRESS RD
SPRING TX
77379-3123
US

IV. Provider business mailing address

8104 SPRING CYPRESS RD
SPRING TX
77379-3123
US

V. Phone/Fax

Practice location:
  • Phone: 281-205-8786
  • Fax:
Mailing address:
  • Phone: 281-205-8786
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number62912
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name: HEIDI GROVER
Title or Position: DIRECTOR
Credential: LPC
Phone: 281-919-3075