Provider Demographics
NPI:1346330420
Name:SUSAN GROSSI & ASSOCIATES, INC.
Entity Type:Organization
Organization Name:SUSAN GROSSI & ASSOCIATES, INC.
Other - Org Name:SUSAN GROSSI MFT EDUCATIONAL CONSULTING
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:RAE
Authorized Official - Last Name:GROSSI
Authorized Official - Suffix:
Authorized Official - Credentials:MFT
Authorized Official - Phone:760-203-2715
Mailing Address - Street 1:189 MISSION OAKS RD
Mailing Address - Street 2:
Mailing Address - City:FALLBROOK
Mailing Address - State:CA
Mailing Address - Zip Code:92028-4162
Mailing Address - Country:US
Mailing Address - Phone:760-203-2715
Mailing Address - Fax:
Practice Address - Street 1:189 MISSION OAKS RD
Practice Address - Street 2:
Practice Address - City:FALLBROOK
Practice Address - State:CA
Practice Address - Zip Code:92028-4162
Practice Address - Country:US
Practice Address - Phone:760-203-2715
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC34343106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty