MEDICARE: NICOLE GROVES LPC

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	101YP2500X	Professional Counselor	85861	TX

General Provider Information

NPI Number	:	1245941921
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICOLE GROVES LPC

Provider Business Mailing Address
First Line	:	706 NECHES ST
Second Line	:
City	:	JACKSONVILLE
State	:	TX
Zip	:	75766-2408
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	706 NECHES ST
Second Line	:
City	:	JACKSONVILLE
State	:	TX
Zip	:	75766-2408
Country	:	US
Telephone Number	:	309-857-0860
Fax Number	:

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

Provider Enumeration Date	:	12/13/2022
Last Update Date	:	02/08/2026

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Directions to “ NICOLE GROVES LPC” Practice Location

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