Individual
LINDA K GROVE-PAUL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
645 S ROGERS ST, BLOOMINGTON, IN 47403-2353
(812) 339-1691
(812) 337-2259
Mailing address
645 S ROGERS ST, BLOOMINGTON, IN 47403-2353
(812) 337-2249
(812) 337-2259
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
34004305A
IN
101YM0800X
Mental Health Counselor
34004305A
IN
1041C0700X
Clinical Social Worker
Primary
34004305A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000263478
ANTHEM PIN
—
Enumeration date
12/01/2005
Last updated
09/04/2012
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