| Doctor Name: | NICOLE GROH |
| NPI Number: | 1053682286 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCPC |
| License Number: | 178.007759 |
| Business Practice Address: | 999 N Plaza Dr Ste 115 Schaumburg, IL - 601735403 |
| Business Phone Number: | 8478683435 |
| Business Fax Number: | |
| Mailing Address: | 999 N Plaza Dr Ste 115, SCHAUMBURG |
| State: | IL |
| Postal Code: | 601735403 |
| Phone Number: | 8478683435 |
| Fax Number: | |
| NPI Enumeration Date: | 01/19/2012 |
| NPI Last Update Date: | 03/17/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 178.007759 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | IL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |