Provider Demographics
NPI:1245524875
Name:GROVERS PSYCHOLOGICAL AND COUNSELING PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:GROVERS PSYCHOLOGICAL AND COUNSELING PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SUMIT
Authorized Official - Middle Name:K
Authorized Official - Last Name:GROVER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:619-321-9474
Mailing Address - Street 1:8241 OAKWAY LN
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-2872
Mailing Address - Country:US
Mailing Address - Phone:619-321-9474
Mailing Address - Fax:
Practice Address - Street 1:884 BRIGHTON RD
Practice Address - Street 2:
Practice Address - City:TONAWANDA
Practice Address - State:NY
Practice Address - Zip Code:14150-8169
Practice Address - Country:US
Practice Address - Phone:716-836-9460
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-31
Last Update Date:2011-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018260103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP63560Medicare UPIN