Provider Demographics
NPI:1588865836
Name:GROVES, KERIN K (PHD, LPC-S)
Entity type:Individual
Prefix:DR
First Name:KERIN
Middle Name:K
Last Name:GROVES
Suffix:
Gender:F
Credentials:PHD, LPC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3505 YUCCA DR
Mailing Address - Street 2:STE 109
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75028-2704
Mailing Address - Country:US
Mailing Address - Phone:940-453-7594
Mailing Address - Fax:
Practice Address - Street 1:3505 YUCCA DR
Practice Address - Street 2:STE 109
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028-2704
Practice Address - Country:US
Practice Address - Phone:940-453-7594
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-31
Last Update Date:2016-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX69302101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional