Provider Demographics
NPI:1477361657
Name:GROSS, SHERI
Entity type:Individual
Prefix:
First Name:SHERI
Middle Name:
Last Name:GROSS
Suffix:
Gender:F
Credentials:
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 211
Mailing Address - Street 2:
Mailing Address - City:CENTER CROSS
Mailing Address - State:VA
Mailing Address - Zip Code:22437-0211
Mailing Address - Country:US
Mailing Address - Phone:804-246-9348
Mailing Address - Fax:
Practice Address - Street 1:17024 THE TRAIL
Practice Address - Street 2:
Practice Address - City:KING AND QUEEN COURT HOU
Practice Address - State:VA
Practice Address - Zip Code:23085-2082
Practice Address - Country:US
Practice Address - Phone:804-785-6102
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-20
Last Update Date:2024-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAPPS-517430101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool