NPIMap

Organization Active NPI

Grove City Psychological Services LLC

  • Psychologist
  • Grove City, OH
National Provider Identifier
1952465668
Registry record updated Apr 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
5180 Issued in OH
Legal business name
GROVE CITY PSYCHOLOGICAL SERVICES LLC
Practice address
3774 Broadway
Grove City, OH 43123-2235
Phone
(614) 871-0035
Fax
(614) 539-0069
NPI assigned
Dec 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2023

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

Authorized official

Name
Jocelyn Good, PHDNPI 1275518342
Title
Co Owner
Phone
(614) 871-0035

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YP2500X
PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103T00000X 5180 OH Primary
Counseling PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103TC1900X
Clinical Social WorkerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1041C0700X

Addresses

Primary practice location

3774 Broadway
Grove City, OH 43123-2235

Mailing address

3774 Broadway
Grove City, OH 43123
Phone (614) 871-0035

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040728001733 OH Part B Supplier - Clinic/Group Practice 5092785873 Receives reassigned benefits from 2 practitioners
Practice locations: Grove City, OH

National Provider Directory

National Provider Directory

Locations

3796 Broadway
Grove City, OH 43123
Phone (614) 871-0035

3774 Broadway
Grove City, OH 43123
Phone (614) 871-0035

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681171200000",
    "number": "1952465668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3774 BROADWAY",
            "city": "GROVE CITY",
            "state": "OH",
            "postal_code": "43123",
            "telephone_number": "614-871-0035",
            "fax_number": "614-539-0069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3774 BROADWAY",
            "city": "GROVE CITY",
            "state": "OH",
            "postal_code": "431232235",
            "telephone_number": "614-871-0035",
            "fax_number": "614-539-0069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GROVE CITY PSYCHOLOGICAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-20",
        "last_updated": "2023-04-11",
        "certification_date": "2023-04-11",
        "status": "A",
        "authorized_official_last_name": "GOOD",
        "authorized_official_first_name": "JOCELYN",
        "authorized_official_title_or_position": "CO OWNER",
        "authorized_official_telephone_number": "614-871-0035",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "OH",
            "license": "5180",
            "primary": true
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grove City, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.