Provider Demographics
NPI:1982442802
Name:LAURA GROFT, PHD, LLC
Entity type:Organization
Organization Name:LAURA GROFT, PHD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:GROFT
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:443-527-5447
Mailing Address - Street 1:219 OAK CT
Mailing Address - Street 2:
Mailing Address - City:SEVERNA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:21146-3121
Mailing Address - Country:US
Mailing Address - Phone:443-527-5447
Mailing Address - Fax:
Practice Address - Street 1:815 RITCHIE HWY STE 205
Practice Address - Street 2:
Practice Address - City:SEVERNA PARK
Practice Address - State:MD
Practice Address - Zip Code:21146-4164
Practice Address - Country:US
Practice Address - Phone:443-527-5447
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-16
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty