Healthcare Provider Details

I. General information

NPI: 1235507211
Provider Name (Legal Business Name): CHRISTINA A GROSSO LCAT, ATR-BC, BCETS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2015
Last Update Date: 01/12/2022
Certification Date: 01/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

66 MAIN ST
BEDFORD HILLS NY
10507-1800
US

IV. Provider business mailing address

1 BRIDEY LN
BREWSTER NY
10509-5015
US

V. Phone/Fax

Practice location:
  • Phone: 917-669-5838
  • Fax:
Mailing address:
  • Phone: 917-669-5838
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code221700000X
TaxonomyArt Therapist
License Number000057
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number000057
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: