PINE GROVE COUNSELING LLC NPI 1255931101

NPI Information

  • NPI: 1255931101
  • Provider Name: PINE GROVE COUNSELING LLC
  • Classification: Clinic/Center - 261QM0801X
  • Specialization: Mental Health (Including Community Mental Health Center)
  • Entity Type: Organization
  • Address: 539 SE VAN LOON TER
    CAPE CORAL, FL
    ZIP 33990
  • Phone: (941) 763-0724

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NPI Details

PINE GROVE COUNSELING LLC is a mental health (including community mental health center) clinic center in Cape Coral, FL. PINE GROVE COUNSELING LLC NPI is 1255931101. The provider is registered as an organization entity type.

The provider's business location address is:

539 SE VAN LOON TER
CAPE CORAL, FL
ZIP 33990-157
Phone: (941) 763-0724
Fax: (239) 567-9671

The provider's authorized official is Christopher Eric Grove .
The authorized official title is Owner and has the following contact phone number (941) 763-0724.

The enumeration date for this NPI number is 10/29/2020 and was last updated on 10/29/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QM0801XClinic/CenterMental Health (Including Community Mental Health Center)Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11992144810MEDICAIDFLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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