Provider Demographics
NPI:1386158343
Name:GROVES, KRISTINA LOUISE (MA, LMFT)
Entity type:Individual
Prefix:
First Name:KRISTINA
Middle Name:LOUISE
Last Name:GROVES
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:KRISTINA
Other - Middle Name:LOUISE
Other - Last Name:BUSLERR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, LMFT
Mailing Address - Street 1:2820 S ALMA SCHOOL RD
Mailing Address - Street 2:STE 18 PMB 541
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85286-4392
Mailing Address - Country:US
Mailing Address - Phone:480-648-8598
Mailing Address - Fax:
Practice Address - Street 1:2820 S ALMA SCHOOL RD
Practice Address - Street 2:STE 18 PMB 541
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85286-4392
Practice Address - Country:US
Practice Address - Phone:480-648-8598
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-28
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA118737106H00000X, 106H00000X
AZ15579106H00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program