Provider Demographics
NPI:1710619135
Name:GRONDEL THERAPY
Entity Type:Organization
Organization Name:GRONDEL THERAPY
Other - Org Name:ABUNDANCE FAMILY THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:GRONDEL
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:360-259-7369
Mailing Address - Street 1:PO BOX 911565
Mailing Address - Street 2:
Mailing Address - City:SAINT GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84791-1565
Mailing Address - Country:US
Mailing Address - Phone:360-259-7369
Mailing Address - Fax:
Practice Address - Street 1:48 S 2500 W STE 240
Practice Address - Street 2:
Practice Address - City:HURRICANE
Practice Address - State:UT
Practice Address - Zip Code:84737-3382
Practice Address - Country:US
Practice Address - Phone:435-236-3177
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-24
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty