Provider Demographics
NPI:1447878996
Name:GROVE COUNSELING INC
Entity type:Organization
Organization Name:GROVE COUNSELING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KELSEY
Authorized Official - Middle Name:
Authorized Official - Last Name:MADAJ
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:847-212-0494
Mailing Address - Street 1:701 E IRVING PARK RD STE 205
Mailing Address - Street 2:
Mailing Address - City:ROSELLE
Mailing Address - State:IL
Mailing Address - Zip Code:60172-2357
Mailing Address - Country:US
Mailing Address - Phone:847-212-0494
Mailing Address - Fax:
Practice Address - Street 1:701 E IRVING PARK RD STE 205
Practice Address - Street 2:
Practice Address - City:ROSELLE
Practice Address - State:IL
Practice Address - Zip Code:60172-2357
Practice Address - Country:US
Practice Address - Phone:847-212-0494
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-10
Last Update Date:2020-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)