Provider Demographics
NPI:1093425357
Name:GROSE, LINSI (LCSW, LICSW)
Entity type:Individual
Prefix:
First Name:LINSI
Middle Name:
Last Name:GROSE
Suffix:
Gender:F
Credentials:LCSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2875 NW 82ND AVE STE 103
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33122-1064
Mailing Address - Country:US
Mailing Address - Phone:954-675-8758
Mailing Address - Fax:
Practice Address - Street 1:2875 NW 82ND AVE STE 103
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33122-1064
Practice Address - Country:US
Practice Address - Phone:954-675-8758
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-28
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW205581041C0700X
VA09040146051041C0700X
NC0176871041C0700X
DCLC2000022531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical