Provider Demographics
NPI:1114721966
Name:GROVE, CASEY (LAPC)
Entity type:Individual
Prefix:
First Name:CASEY
Middle Name:
Last Name:GROVE
Suffix:
Gender:
Credentials:LAPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1310 VALLEY VIEW BLVD
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16602-6080
Mailing Address - Country:US
Mailing Address - Phone:814-944-9970
Mailing Address - Fax:814-201-2960
Practice Address - Street 1:705 12TH ST
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16602-2419
Practice Address - Country:US
Practice Address - Phone:814-944-9970
Practice Address - Fax:814-201-2960
Is Sole Proprietor?:No
Enumeration Date:2025-04-02
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAPC001136101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health