Organization
SHANNON L GROH, MA, LPC COUNSELING, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNON L GROH LPC (OWNER/COUNSELOR)
(269) 921-3643
Entity
Organization
Contact information
Practice address
2600 MORTON AVE, SAINT JOSEPH, MI 49085-2141
(269) 921-3643
Mailing address
3480 WYNDWICKE DR, SAINT JOSEPH, MI 49085-8605
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
6410103838
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6401013838
COUNSELING SERVICES
MI
Enumeration date
10/22/2013
Last updated
10/22/2013
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