Provider Demographics
NPI:1265638274
Name:GROFF, PAUL R (MA, LMHC)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:R
Last Name:GROFF
Suffix:
Gender:M
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 SETTLEMENT WAY
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03062-4438
Mailing Address - Country:US
Mailing Address - Phone:603-566-7027
Mailing Address - Fax:
Practice Address - Street 1:97 CENTRAL ST STE 205B
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01852-1931
Practice Address - Country:US
Practice Address - Phone:617-682-0110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-26
Last Update Date:2013-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7425101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health