Grove Avenue Professional Associates, Inc.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

0810000730 Issued in VA

Legal business name

GROVE AVENUE PROFESSIONAL ASSOCIATES, INC.

Practice address

505 Libbie Ave
Richmond, VA 23226-2617

Phone

(804) 288-8823

Fax

(804) 288-6423

NPI assigned

May 14, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Leslie Ellis Montgomery, PH.D.NPI 1841230406

Title

President

Phone

(804) 288-8823

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Leslie E Montgomery, PH D

  • Clinical Psychologist
  • Richmond, VA
  • NPI 1841230406
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1215143789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 LIBBIE AVE",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232262617",
            "telephone_number": "804-288-8823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 LIBBIE AVE",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232262617",
            "telephone_number": "804-288-8823",
            "fax_number": "804-288-6423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GROVE AVENUE PROFESSIONAL ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MONTGOMERY",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_middle_name": "ELLIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "804-288-8823",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810000730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Grove Ave Eye Center PC
• Grove House
• Grove Renewal
• Cory Grove
• Jessica Grove, PSYD
• Marie Katherine Grove, MD

• Clinical Psychologist in Richmond, VA
• Providers in Richmond, VA by specialty
• Clinical Psychologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.