Provider Demographics
NPI:1184480832
Name:GROVE, ERIN RENEE
Entity type:Individual
Prefix:MS
First Name:ERIN
Middle Name:RENEE
Last Name:GROVE
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:ERIN
Other - Middle Name:
Other - Last Name:KOUVAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:503 CORNELL DR
Mailing Address - Street 2:
Mailing Address - City:BROADVIEW HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44147-4417
Mailing Address - Country:US
Mailing Address - Phone:330-647-0877
Mailing Address - Fax:
Practice Address - Street 1:7650 CHIPPEWA RD
Practice Address - Street 2:SUITE 310
Practice Address - City:BRECKSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44141-2319
Practice Address - Country:US
Practice Address - Phone:216-716-7777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-21
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health