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General NPI Number Information
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NPI Number | 1801121538
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Entity Type | Individual
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Provider Name | VIVIAN GROUT PHD, LMHC, LMFT
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Gender | Female
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Dates
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Enumeration Date | 10/14/2009
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Last Update Date | 01/16/2025
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Provider Practice Location Address
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Address Line | 7035 BERACASA WAY STE 204
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City | BOCA RATON
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State | FL
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Zip | 33433-3408
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Country | US
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Telephone | 561-305-4197
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Fax |
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Provider Business Mailing Address
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Address Line | 10569 E KEY DR
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City | BOCA RATON
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State | FL
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Zip | 33498-4510
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Country | US
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Telephone | 561-305-4197
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH10064
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License Number State | FL
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