Provider Demographics
NPI:1669258422
Name:GROSS, CINDY DEVORAH (LMSW)
Entity type:Individual
Prefix:MRS
First Name:CINDY
Middle Name:DEVORAH
Last Name:GROSS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:MRS
Other - First Name:SARAH
Other - Middle Name:DEVORAH
Other - Last Name:GROSS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMSW
Mailing Address - Street 1:564 CUMBERLAND AVE
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-2651
Mailing Address - Country:US
Mailing Address - Phone:718-360-8625
Mailing Address - Fax:
Practice Address - Street 1:564 CUMBERLAND AVE
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-2651
Practice Address - Country:US
Practice Address - Phone:718-360-8625
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-06
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY059104-01104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker