MEDICARE: MR. DAVID LAWRENCE MCGRUDER JR. LPC-A

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	102523	TX

General Provider Information

NPI Number	:	1164357109
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DAVID LAWRENCE MCGRUDER JR. LPC-A

Provider Business Mailing Address
First Line	:	1052 WOOD STREAM DR
Second Line	:
City	:	GRAND PRAIRIE
State	:	TX
Zip	:	75052-8837
Country	:	US
Telephone Number	:	682-203-2274
Fax Number	:

Provider Business Practice Location Address
First Line	:	1052 WOOD STREAM DR
Second Line	:
City	:	GRAND PRAIRIE
State	:	TX
Zip	:	75052-8837
Country	:	US
Telephone Number	:	682-203-2274
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/12/2026
Last Update Date	:	06/12/2026

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Directions to “ MR. DAVID LAWRENCE MCGRUDER JR. LPC-A” Practice Location

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