MEDICARE: GROUNDED MENTAL HEALTH CARE, PLLC

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	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1841973393
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GROUNDED MENTAL HEALTH CARE, PLLC

Provider Business Mailing Address
First Line	:	6304 WINTER SPRING DR
Second Line	:
City	:	WAKE FOREST
State	:	NC
Zip	:	27587-7150
Country	:	US
Telephone Number	:	919-823-3515
Fax Number	:

Provider Business Practice Location Address
First Line	:	6304 WINTER SPRING DR
Second Line	:
City	:	WAKE FOREST
State	:	NC
Zip	:	27587-7150
Country	:	US
Telephone Number	:	919-823-3515
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	CATHERINE GRANT PEOPLES
Credential	:	LCSW
Telephone Number	:	919-823-3515

Provider Enumeration Date	:	08/10/2023
Last Update Date	:	08/10/2023

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