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NPI Code Detail

MEDICARE: LINDA K GROVE-PAUL LCSW

MEDICARE: LINDA K GROVE-PAUL LCSW
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
11041C0700XClinical Social Worker34004305AIN
2101YA0400XAddiction (Substance Use Disorder) Counselor34004305AIN
3101YM0800XMental Health Counselor34004305AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000000263478OTHERANTHEM PIN

General Provider Information

NPI Number : 1326022518
Entity Type Code : Individual
Provider Name (Legal Business Name) : LINDA K GROVE-PAUL LCSW
Provider Business Mailing Address
First Line : 645 S ROGERS ST
Second Line :
City : BLOOMINGTON
State : IN
Zip : 47403-2353
Country : US
Telephone Number : 812-337-2249
Fax Number : 812-337-2259
Provider Business Practice Location Address
First Line : 645 S ROGERS ST
Second Line :
City : BLOOMINGTON
State : IN
Zip : 47403-2353
Country : US
Telephone Number : 812-339-1691
Fax Number : 812-337-2259
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/01/2005
Last Update Date : 09/04/2012

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Directions to “ LINDA K GROVE-PAUL LCSW” Practice Location

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