Provider Demographics
NPI:1023235355
Name:GROSS, CATHY S (MS,CRC,LPC,QRP,CLCP)
Entity type:Individual
Prefix:MRS
First Name:CATHY
Middle Name:S
Last Name:GROSS
Suffix:
Gender:F
Credentials:MS,CRC,LPC,QRP,CLCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1751
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25326-1751
Mailing Address - Country:US
Mailing Address - Phone:304-344-1751
Mailing Address - Fax:304-344-1799
Practice Address - Street 1:179 SUMMERS ST
Practice Address - Street 2:PEOPLES BUILDING SUITE 607
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25301-2163
Practice Address - Country:US
Practice Address - Phone:304-296-2800
Practice Address - Fax:304-296-2055
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor