Provider Demographics
NPI:1063599769
Name:GROSS, GENE (LCSW)
Entity type:Individual
Prefix:
First Name:GENE
Middle Name:
Last Name:GROSS
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4500 E 9TH AVE
Mailing Address - Street 2:SUITE 740
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80220-3900
Mailing Address - Country:US
Mailing Address - Phone:720-941-8497
Mailing Address - Fax:303-321-2368
Practice Address - Street 1:4500 E 9TH AVE
Practice Address - Street 2:SUITE 740
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220-3900
Practice Address - Country:US
Practice Address - Phone:720-941-8497
Practice Address - Fax:303-321-2368
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCSW-5541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical