| Grounded Therapy LLC | |
|
250 N Main St Crown Point IN 46307-3278 | |
| (219) 707-9007 | |
| Not Available |
| Full Name | Grounded Therapy LLC |
|---|---|
| Speciality | Social Worker |
| Location | 250 N Main St, Crown Point, Indiana |
| Authorized Official Name and Position | Jennifer Hathaway (CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 2197079007 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Grounded Therapy LLC 250 N Main St Ste 11f Crown Point IN 46307-3279 Ph: (219) 707-9007 | Grounded Therapy LLC 250 N Main St Crown Point IN 46307-3278 Ph: (219) 707-9007 |
| NPI Number | 1356217103 |
|---|---|
| Provider Enumeration Date | 10/16/2025 |
| Last Update Date | 04/09/2026 |
| Certification Date | 04/09/2026 |
| Medicare PECOS PAC ID | 5092284935 |
|---|---|
| Medicare Enrollment ID | O20260520000912 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356217103 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | () | Primary |
| Provider Name | Jennifer Hathaway |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194691949 PECOS PAC ID: 6901375849 Enrollment ID: I20260520001027 |
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