| Grove: A Healing Collective | |
|
3380 Walnut Grove Rd Sparta TN 38583-5365 | |
| (931) 372-7117 | |
| (931) 372-7119 |
| Full Name | Grove: A Healing Collective |
|---|---|
| Speciality | Counselor |
| Location | 3380 Walnut Grove Rd, Sparta, Tennessee |
| Authorized Official Name and Position | Susan A. Freitag (CHIEF MANAGER) |
| Authorized Official Contact | 9313727117 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Grove: A Healing Collective 3380 Walnut Grove Rd Sparta TN 38583-5365 Ph: (931) 372-7117 | Grove: A Healing Collective 3380 Walnut Grove Rd Sparta TN 38583-5365 Ph: (931) 372-7117 |
| NPI Number | 1548644735 |
|---|---|
| Provider Enumeration Date | 07/17/2015 |
| Last Update Date | 01/08/2024 |
| Certification Date | 01/08/2024 |
| Medicare PECOS PAC ID | 6800248212 |
|---|---|
| Medicare Enrollment ID | O20240122003737 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548644735 | NPI | - | NPPES |
| Provider Name | Anne Loubier |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1003210139 PECOS PAC ID: 2264875004 Enrollment ID: I20240208000831 |
| Provider Name | Antonio Deon Taylor |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1912273608 PECOS PAC ID: 9436593266 Enrollment ID: I20240220001527 |
| Provider Name | Sarah Gabrielle Campbell-benitez |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1396458626 PECOS PAC ID: 0840636312 Enrollment ID: I20240307001303 |
| Provider Name | Adam August Heckmann |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1982824355 PECOS PAC ID: 0345686689 Enrollment ID: I20240309000193 |
| Provider Name | Isaac D Evans |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1386216802 PECOS PAC ID: 1456798065 Enrollment ID: I20240319000956 |
| Provider Name | Susan A Freitag |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1942533609 PECOS PAC ID: 8628420932 Enrollment ID: I20240328002601 |
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