Provider Demographics
NPI:1669028700
Name:GROVE, KATRINA (LMSW)
Entity Type:Individual
Prefix:
First Name:KATRINA
Middle Name:
Last Name:GROVE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:KATRINA
Other - Middle Name:
Other - Last Name:ISZLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2777 47TH ST S APT 209
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58104-8550
Mailing Address - Country:US
Mailing Address - Phone:701-659-0793
Mailing Address - Fax:
Practice Address - Street 1:3911 20TH AVE S
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-4705
Practice Address - Country:US
Practice Address - Phone:701-271-1613
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-14
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical