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NPI Code Detail

MEDICARE: EMILY GROSS LPC

MEDICARE: EMILY GROSS LPC
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
1101YP2500XProfessional CounselorTEL1070LA
2101YP2500XProfessional Counselor0020662CO
3101YP2500XProfessional Counselor77236TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
177236OTHERTXTEXAS BEHAVIORAL HEALTH EXECUTIVE COUNCIL

General Provider Information

NPI Number : 1932707882
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMILY GROSS LPC
Provider Business Mailing Address
First Line : 1011 COLLEGE AVE
Second Line :
City : JACKSONVILLE
State : TX
Zip : 75766-3307
Country : US
Telephone Number : 903-589-9000
Fax Number : 903-589-3443
Provider Business Practice Location Address
First Line : 1011 COLLEGE AVE
Second Line :
City : JACKSONVILLE
State : TX
Zip : 75766-3307
Country : US
Telephone Number : 903-589-9000
Fax Number : 903-589-3443
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/13/2020
Last Update Date : 03/09/2026

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