Provider Demographics
NPI:1255364691
Name:GROSCH, SHARON M (LCSW)
Entity type:Individual
Prefix:MS
First Name:SHARON
Middle Name:M
Last Name:GROSCH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 COUNTRYWOOD DR
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:TN
Mailing Address - Zip Code:37087-8934
Mailing Address - Country:US
Mailing Address - Phone:615-444-7885
Mailing Address - Fax:615-444-7811
Practice Address - Street 1:320 WEST MAIN ST
Practice Address - Street 2:SUITE B
Practice Address - City:LEBANON
Practice Address - State:TN
Practice Address - Zip Code:37087
Practice Address - Country:US
Practice Address - Phone:615-444-7885
Practice Address - Fax:615-444-7811
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-09
Last Update Date:2008-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLSW45601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4124930OtherBLUE CROSS BLUE SHIELD
0007312821OtherAETNA
TN4124930OtherBLUE CROSS BLUE SHIELD