Provider Demographics
NPI:1417399130
Name:GROVE, TERRIANN LYNN (LPC)
Entity Type:Individual
Prefix:
First Name:TERRIANN
Middle Name:LYNN
Last Name:GROVE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1023 LASALLE LN
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16602-7421
Mailing Address - Country:US
Mailing Address - Phone:814-932-6591
Mailing Address - Fax:888-853-4598
Practice Address - Street 1:615 HOWARD AVE STE 212
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16601-4813
Practice Address - Country:US
Practice Address - Phone:814-932-6591
Practice Address - Fax:888-853-4598
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-23
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X, 101YM0800X, 101YA0400X
PAPC009002101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)