Provider Demographics
NPI:1043594674
Name:LATORRE-GROSS, ROSA (LMHC)
Entity Type:Individual
Prefix:MS
First Name:ROSA
Middle Name:
Last Name:LATORRE-GROSS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7409 37TH AVE
Mailing Address - Street 2:SUITE 315
Mailing Address - City:JACKSON HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11372-6300
Mailing Address - Country:US
Mailing Address - Phone:718-672-1705
Mailing Address - Fax:718-672-2027
Practice Address - Street 1:7409 37TH AVE
Practice Address - Street 2:SUITE 315
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-6300
Practice Address - Country:US
Practice Address - Phone:718-672-1705
Practice Address - Fax:718-672-2027
Is Sole Proprietor?:No
Enumeration Date:2011-09-30
Last Update Date:2011-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP80503101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health