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Organization
PINE GROVE COUNSELING LLC
Active
Organization
PINE GROVE COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER ERIC GROVE LCSW (OWNER)
(941) 763-0724
Entity
Organization
Contact information
Practice address
320 LAKE WIRE DRIVE, UNIT 417, LAKELAND, FL 33815
(941) 763-0724
(239) 567-9671
Mailing address
320 LAKE WIRE DRIVE, UNIT 417, LAKELAND, FL 33815
(941) 763-0724
(239) 567-9671
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1992144810
—
FL
Enumeration date
10/29/2020
Last updated
09/04/2026
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