Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mary Lee Roske-Groth, LICSW, LADC

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1194897652

Mary Lee Roske-Groth, LICSW, LADC is an Addiction (Substance Use Disorder) Counselor in Minneapolis, Minnesota. Practices as a sole proprietor. Licensed in Minnesota.

Licensed in
MN
In the registry since
2006
Specialties on file
2
What do these letters mean?
LICSW — Licensed Independent Clinical Social Worker
The title some states use for an independently practising clinical social worker.
LADC — Licensed Alcohol and Drug Counselor
A licensed addiction counsellor.

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Practice location Address checks out

410 Church St SE Boynton Health Service
Minneapolis, MN 55455-0340
Phone: (612) 624-1444
Fax: (612) 625-7155
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 14998 (MN)
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X · Licence 300299 (MN)

Record details

NPI number1194897652
Entity typeIndividual (Type 1)
GenderFemale
Credentials LICSW , LADC
Sole proprietorYes
NPI enumeratedNovember 13, 2006
Last updated in NPPESAugust 25, 2010

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