Healthcare Provider Details

I. General information

NPI: 1306345889
Provider Name (Legal Business Name): ERIN GROVER LCSW, TRS, CTRS, SEP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/09/2018
Last Update Date: 01/22/2025
Certification Date: 01/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

148 S 550 E
ENTERPRISE UT
84725-0891
US

IV. Provider business mailing address

PO BOX 891
ENTERPRISE UT
84725-0891
US

V. Phone/Fax

Practice location:
  • Phone: 435-817-6116
  • Fax:
Mailing address:
  • Phone: 435-817-6116
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6550522-3501
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW-22196
License Number StateAZ

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: