Provider Demographics
NPI:1942391529
Name:GROVE PSYCHOTHERAPY, INC.
Entity Type:Organization
Organization Name:GROVE PSYCHOTHERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:C
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LP
Authorized Official - Phone:612-379-2640
Mailing Address - Street 1:219 MAIN ST SE
Mailing Address - Street 2:STE 400
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55414-2124
Mailing Address - Country:US
Mailing Address - Phone:612-379-2640
Mailing Address - Fax:612-379-2820
Practice Address - Street 1:219 MAIN ST SE
Practice Address - Street 2:STE 400
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55414-2124
Practice Address - Country:US
Practice Address - Phone:612-379-2640
Practice Address - Fax:612-379-2820
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty