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General NPI Number Information
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NPI Number | 1821977083
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Entity Type | Individual
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Provider Name | MAIRE CATHERINE GRUPP LSW
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Gender | Female
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Dates
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Enumeration Date | 08/30/2025
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Last Update Date | 09/01/2025
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Provider Practice Location Address
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Address Line | 136 ROXBURY PARK
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City | GOSHEN
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State | IN
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Zip | 46526-1730
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Country | US
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Telephone | 317-210-3075
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Fax | 317-204-8787
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Provider Business Mailing Address
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Address Line | 24007 MERRILYN CT
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City | FARMINGTON
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State | MI
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Zip | 48336-2333
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Country | US
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Telephone | 317-678-7337
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Fax | 317-204-8787
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 33012642A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 6851120663
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License Number State | MI
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