MEDICARE: SARA GROSS COUNSELING INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	MFT. 0001266	CO

General Provider Information

NPI Number	:	1427591965
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SARA GROSS COUNSELING INC

Provider Business Mailing Address
First Line	:	PO BOX 76510
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80970-6510
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7035 CAMPUS DR
Second Line	:	STE 804
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80920-3164
Country	:	US
Telephone Number	:	719-510-3899
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	SARA GROSS
Credential	:	LMFT
Telephone Number	:	719-510-3899

Provider Enumeration Date	:	12/01/2016
Last Update Date	:	02/12/2024

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