Provider Demographics
NPI:1194394577
Name:GROSS, BRYAN F (LPC)
Entity Type:Individual
Prefix:
First Name:BRYAN
Middle Name:F
Last Name:GROSS
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7625 W. HUTCHINSON AVE.
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15218
Mailing Address - Country:US
Mailing Address - Phone:412-352-1317
Mailing Address - Fax:
Practice Address - Street 1:7625 W. HUTCHINSON AVE.
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15218
Practice Address - Country:US
Practice Address - Phone:412-352-1317
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-21
Last Update Date:2021-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC010892101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional