Individual provider Active NPI

Ava Elizabeth Grover, MA, LPCC

  • Mental Health Counselor
  • Saint Paul, MN
National Provider Identifier
1912695461
Registry record updated Apr 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
CC03600 Issued in MN
Practice address
1919 University Ave W Ste 6
Saint Paul, MN 55104-3435
Phone
(651) 641-1555
Fax
(651) 641-0340
NPI assigned
Apr 24, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X CC03600 MN Primary

Addresses

Primary practice location

1919 University Ave W Ste 6
Saint Paul, MN 55104-3435

Mailing address

3753 Fremont Ave N
Minneapolis, MN 55412-2013
Phone (612) 440-7811

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240211000053 MN Practitioner - Mental Health Counselor 5698118263

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
CC03600MNMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1682294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682294400000",
    "number": "1912695461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3753 FREMONT AVE N",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554122013",
            "telephone_number": "612-440-7811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 UNIVERSITY AVE W STE 6",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551043435",
            "telephone_number": "651-641-1555",
            "fax_number": "651-641-0340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROVER",
        "first_name": "AVA",
        "middle_name": "ELIZABETH",
        "credential": "MA, LPCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-04-24",
        "last_updated": "2023-04-24",
        "certification_date": "2023-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "CC03600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.