Provider Demographics
NPI:1083775308
Name:GROSS, STEVEN N
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:N
Last Name:GROSS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:277 MAIN ST
Mailing Address - Street 2:4TH FLOOR
Mailing Address - City:GREENFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01301-3262
Mailing Address - Country:US
Mailing Address - Phone:413-772-6080
Mailing Address - Fax:
Practice Address - Street 1:277 MAIN ST
Practice Address - Street 2:4TH FLOOR
Practice Address - City:GREENFIELD
Practice Address - State:MA
Practice Address - Zip Code:01301-3262
Practice Address - Country:US
Practice Address - Phone:413-772-6080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10240981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical