MEDICARE: ERIN GROETEKE 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	78450	TX

General Provider Information

NPI Number	:	1730936113
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIN GROETEKE LPC

Provider Business Mailing Address
First Line	:	2224 S PINEY POINT RD
Second Line	:	APT 216
City	:	HOUSTON
State	:	TX
Zip	:	77063-1417
Country	:	US
Telephone Number	:	308-390-8978
Fax Number	:

Provider Business Practice Location Address
First Line	:	2224 S PINEY POINT RD
Second Line	:	APT 216
City	:	HOUSTON
State	:	TX
Zip	:	77063-1417
Country	:	US
Telephone Number	:	308-390-8978
Fax Number	:

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

Provider Enumeration Date	:	05/02/2024
Last Update Date	:	05/02/2024

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