# ASPEN GROVE FAMILY THERAPY, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1366905416
- **Authorized official:** MICHAEL ROBERT WHITEHEAD PHD, LMFT (OWNER)
- **Authorized official phone:** (509) 392-1874

## Contact information

- **Practice address:** 762 FALLS AVE, TWIN FALLS, ID 83301-3316
- **Practice address phone:** (208) 258-7681
- **Mailing address:** 762 FALLS AVE, TWIN FALLS, ID 83301-3316
- **Mailing address phone:** (208) 258-7681
- **Mailing address fax:** (208) 907-0874

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 106H00000X | Marriage & Family Therapist | — | — | Yes |

## Other

- **Enumeration date:** 04/07/2019
- **Last updated:** 04/24/2025