| Grove City Psychological Services Llc | |
|
3774 Broadway Grove City OH 43123-2235 | |
| (614) 871-0035 | |
| (614) 539-0069 |
| Full Name | Grove City Psychological Services Llc |
|---|---|
| Speciality | Psychologist |
| Location | 3774 Broadway, Grove City, Ohio |
| Authorized Official Name and Position | Jocelyn Good (CO OWNER) |
| Authorized Official Contact | 6148710035 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Grove City Psychological Services Llc 3774 Broadway Grove City OH 43123 Ph: (614) 871-0035 | Grove City Psychological Services Llc 3774 Broadway Grove City OH 43123-2235 Ph: (614) 871-0035 |
| NPI Number | 1952465668 |
|---|---|
| Provider Enumeration Date | 12/20/2006 |
| Last Update Date | 04/11/2023 |
| Certification Date | 04/11/2023 |
| Medicare PECOS PAC ID | 5092785873 |
|---|---|
| Medicare Enrollment ID | O20040728001733 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952465668 | NPI | - | NPPES |
| Provider Name | Jim R Broyles |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1689651705 PECOS PAC ID: 8729058508 Enrollment ID: I20120213000460 |
| Provider Name | Joseph Michael Waters |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1790037521 PECOS PAC ID: 8123470424 Enrollment ID: I20240123002131 |
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