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General NPI Number Information
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NPI Number | 1356741029
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Entity Type | Organization
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Legal Business Name | ANNE D. GROSS, MSW, LMSW
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Dates
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Enumeration Date | 08/29/2014
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Last Update Date | 08/29/2014
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Provider Practice Location Address
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Address Line | 317 UNION ST
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City | MILFORD
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State | MI
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Zip | 48381-1983
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Country | US
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Telephone | 248-240-1207
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Fax | 248-887-3007
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Provider Business Mailing Address
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Address Line | 2708 N TIPSICO LAKE RD
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City | HARTLAND
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State | MI
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Zip | 48353-3251
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Country | US
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Telephone | 248-240-1207
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Fax | 248-887-3007
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Authorized Official
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Title or Position | OWNER/DIRECTOR
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Name | MS. ANNE DENICE GROSS
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Credential | LMSW
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Telephone | 248-240-1207
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 6801067250
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6801067250
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License Number State | MI
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