Provider Demographics
NPI:1568879880
Name:GROEN, CAMERON (LMFT)
Entity Type:Individual
Prefix:
First Name:CAMERON
Middle Name:
Last Name:GROEN
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 LAURENS RD STE 4D
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29607-1860
Mailing Address - Country:US
Mailing Address - Phone:864-990-4452
Mailing Address - Fax:
Practice Address - Street 1:109 LAURENS RD STE 4D
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-1860
Practice Address - Country:US
Practice Address - Phone:864-990-4452
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-18
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2567106H00000X
SC6993106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist