Provider Demographics
NPI:1164392981
Name:GROSSE, KATHLEEN (LPCA)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:
Last Name:GROSSE
Suffix:
Gender:F
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3004 HANCOCK DR
Mailing Address - Street 2:
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06811-2649
Mailing Address - Country:US
Mailing Address - Phone:203-501-5198
Mailing Address - Fax:
Practice Address - Street 1:3004 HANCOCK DR
Practice Address - Street 2:
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06811-2649
Practice Address - Country:US
Practice Address - Phone:203-501-5198
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-11-06
Last Update Date:2025-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT9104101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health