Provider Demographics
NPI:1447314612
Name:GROTE, MONA M (LCSW)
Entity type:Individual
Prefix:MRS
First Name:MONA
Middle Name:M
Last Name:GROTE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MISS
Other - First Name:MONA
Other - Middle Name:M
Other - Last Name:BIBB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:14407 PIKE ROAD
Mailing Address - Street 2:404
Mailing Address - City:BOWLING GREEN
Mailing Address - State:MO
Mailing Address - Zip Code:63334
Mailing Address - Country:US
Mailing Address - Phone:573-324-2979
Mailing Address - Fax:
Practice Address - Street 1:734 W MONROE ST
Practice Address - Street 2:
Practice Address - City:MEXICO
Practice Address - State:MO
Practice Address - Zip Code:65265-1970
Practice Address - Country:US
Practice Address - Phone:573-582-0292
Practice Address - Fax:573-581-6036
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0054471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical