Provider Demographics
NPI:1780921478
Name:GROVER, MARY JANE I (LBSW)
Entity type:Individual
Prefix:MS
First Name:MARY
Middle Name:JANE
Last Name:GROVER
Suffix:I
Gender:F
Credentials:LBSW
Other - Prefix:MRS
Other - First Name:MARY
Other - Middle Name:JANE
Other - Last Name:TOOMEY
Other - Suffix:I
Other - Last Name Type:Professional Name
Other - Credentials:LBSW
Mailing Address - Street 1:6550 S CEDAR ST
Mailing Address - Street 2:PO BOX 5
Mailing Address - City:FALMOUTH
Mailing Address - State:MI
Mailing Address - Zip Code:49632-5104
Mailing Address - Country:US
Mailing Address - Phone:231-878-7116
Mailing Address - Fax:231-775-1692
Practice Address - Street 1:527 COBB ST
Practice Address - Street 2:
Practice Address - City:CADILLAC
Practice Address - State:MI
Practice Address - Zip Code:49601-2540
Practice Address - Country:US
Practice Address - Phone:231-876-3312
Practice Address - Fax:231-775-1692
Is Sole Proprietor?:No
Enumeration Date:2013-01-15
Last Update Date:2025-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6802084744104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker