Provider Demographics
NPI:1679230445
Name:DEGROAT, DEVIN (NONE)
Entity Type:Individual
Prefix:
First Name:DEVIN
Middle Name:
Last Name:DEGROAT
Suffix:
Gender:M
Credentials:NONE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1375 US HIGHWAY 42 SE
Mailing Address - Street 2:STE C
Mailing Address - City:LONDON
Mailing Address - State:OH
Mailing Address - Zip Code:43140-9548
Mailing Address - Country:US
Mailing Address - Phone:614-879-8067
Mailing Address - Fax:614-503-0899
Practice Address - Street 1:1375 US HIGHWAY 42 SE
Practice Address - Street 2:STE C
Practice Address - City:LONDON
Practice Address - State:OH
Practice Address - Zip Code:43140-9548
Practice Address - Country:US
Practice Address - Phone:614-845-8652
Practice Address - Fax:614-503-0899
Is Sole Proprietor?:No
Enumeration Date:2021-11-29
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OHC.2304872-TRNE101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health