MR. JOHN STEPHEN GROVE LAC
NPI 1639371453
Counselor - Addiction (Substance Use Disorder) in Bismarck, ND
Active since June 04, 2007
About Mr. John Stephen Grove Lac NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MR. JOHN STEPHEN GROVE LAC (NPI 1639371453) is an individual addiction (substance use disorder) provider in Bismarck, North Dakota, licensed in North Dakota (LAC1040) and active in the NPI registry since June 2007.
NPPES Registry Identity
NPI1639371453
Entity TypeIndividualMale
Primary Taxonomy101YA0400X
Provider Legal NameMR. JOHN STEPHEN GROVECredential: LAC
Location Address1138 SUMMIT BLVDBismarck, ND 58504-5280
Mailing Address1138 Summit BlvdBismarck, ND 58504-5280 · (701) 224-1261
Phone(701) 224-1261
Sole ProprietorNo
Enumeration DateJune 4, 2007
Last NPPES UpdateJuly 8, 2007
✔ NPI 1639371453 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
License✔ Licensed in ND · LAC1040
1138 SUMMIT BLVD, Bismarck, ND 58504
Other Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1639371453, enumerated as an "individual" on June 04, 2007.
The provider is located at 1138 SUMMIT BLVD BISMARCK, ND 58504 and the phone number is (701) 224-1261.
Counselor with taxonomy code 101YA0400X and a focus in Addiction (Substance Use Disorder).
