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General NPI Number Information
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NPI Number | 1972286524
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Entity Type | Organization
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Legal Business Name | GROVE COUNSELING LLC
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Dates
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Enumeration Date | 08/10/2023
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Last Update Date | 08/10/2023
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Provider Practice Location Address
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Address Line | 63 PUTNAM ST STE 202
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City | SARATOGA SPRINGS
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State | NY
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Zip | 12866-3285
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Country | US
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Telephone | 518-526-0831
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Fax |
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Provider Business Mailing Address
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Address Line | 4 WILLEM WAY
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City | BALLSTON LAKE
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State | NY
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Zip | 12019-1943
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | COO
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Name | MR. RONALD SHEPARD
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Credential |
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Telephone | 518-526-0831
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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