Provider Demographics
NPI:1275019721
Name:GRUVER, KIMBERLY (MS, LPC)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:
Last Name:GRUVER
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:
Other - Last Name:GEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:1157 CALIFORNIA RD
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:16950-8817
Mailing Address - Country:US
Mailing Address - Phone:570-418-1226
Mailing Address - Fax:
Practice Address - Street 1:1157 CALIFORNIA RD
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:PA
Practice Address - Zip Code:16950-8817
Practice Address - Country:US
Practice Address - Phone:570-418-1226
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-18
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
757775OtherNCC