Provider Demographics
NPI:1063980381
Name:GROVE, DENNIS GORDON (LMHC CDPT)
Entity type:Individual
Prefix:MR
First Name:DENNIS
Middle Name:GORDON
Last Name:GROVE
Suffix:
Gender:M
Credentials:LMHC CDPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 N 36TH ST, STE 300
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103
Mailing Address - Country:US
Mailing Address - Phone:206-216-5000
Mailing Address - Fax:206-216-5002
Practice Address - Street 1:701 N 36TH ST, STE 300
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103
Practice Address - Country:US
Practice Address - Phone:206-216-5000
Practice Address - Fax:206-216-5002
Is Sole Proprietor?:No
Enumeration Date:2018-11-05
Last Update Date:2020-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60336500101YM0800X
WACP60984419101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)