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Organization

MATT GROTH COUNSELING PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MATTHEW GROTH LPC (MANAGING SOLE MEMBER)
(325) 617-2997
Entity
Organization

Contact information

Practice address
1 N MILTON ST STE 6, SAN ANGELO, TX 76901-3261
(325) 617-2997
Mailing address
1 N MILTON ST STE 6, SAN ANGELO, TX 76901-3261
(325) 617-2997

Taxonomy

Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
261QM0855X
Adolescent and Children Mental Health Clinic/Center

Other

Enumeration date
08/04/2021
Last updated
11/30/2021
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