Healthcare Provider Details

I. General information

NPI: 1689561698
Provider Name (Legal Business Name): GROUNDED GROWTH COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2025
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2125 HEIGHTS DR STE 1B
EAU CLAIRE WI
54701-6146
US

IV. Provider business mailing address

2125 HEIGHTS DR STE 1B
EAU CLAIRE WI
54701-6146
US

V. Phone/Fax

Practice location:
  • Phone: 715-506-5150
  • Fax:
Mailing address:
  • Phone: 715-506-5150
  • 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: KATRINA MAHAN
Title or Position: OWNER
Credential: LPC
Phone: 715-506-5150