Provider Demographics
NPI:1407547128
Name:GRIFFIN GROSS, JULI ELIZABETH (LCPC)
Entity Type:Individual
Prefix:MRS
First Name:JULI
Middle Name:ELIZABETH
Last Name:GRIFFIN GROSS
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1013 RAILBED DR
Mailing Address - Street 2:
Mailing Address - City:ODENTON
Mailing Address - State:MD
Mailing Address - Zip Code:21113-3733
Mailing Address - Country:US
Mailing Address - Phone:410-499-3842
Mailing Address - Fax:
Practice Address - Street 1:1013 RAILBED DR
Practice Address - Street 2:
Practice Address - City:ODENTON
Practice Address - State:MD
Practice Address - Zip Code:21113-3733
Practice Address - Country:US
Practice Address - Phone:410-499-3842
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-15
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC2402101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional