Healthcare Provider Details

I. General information

NPI: 1407547128
Provider Name (Legal Business Name): JULI ELIZABETH GRIFFIN GROSS LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/15/2023
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12345 PARKLAWN DR STE 200
ROCKVILLE MD
20852-1725
US

IV. Provider business mailing address

12345 PARKLAWN DR STE 200
ROCKVILLE MD
20852-1725
US

V. Phone/Fax

Practice location:
  • Phone: 410-499-3842
  • Fax:
Mailing address:
  • Phone: 410-499-3842
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLC2402
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number11616
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: