Provider Demographics
NPI:1811487986
Name:GROTE, KAITLYN M (LPCC)
Entity type:Individual
Prefix:
First Name:KAITLYN
Middle Name:M
Last Name:GROTE
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4790 RED BANK RD STE 128
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45227-1509
Mailing Address - Country:US
Mailing Address - Phone:513-731-3346
Mailing Address - Fax:
Practice Address - Street 1:4790 RED BANK RD STE 128
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45227-1509
Practice Address - Country:US
Practice Address - Phone:513-731-3346
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-15
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.1800956-TRNE390200000X
OHE.2102555101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH00000OtherLICENSURE BOARD