Provider Demographics
NPI:1811225832
Name:GROSS, JOYCE FAITH (LMSW)
Entity type:Individual
Prefix:
First Name:JOYCE
Middle Name:FAITH
Last Name:GROSS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24909 W WATKINS ST
Mailing Address - Street 2:
Mailing Address - City:BUCKEYE
Mailing Address - State:AZ
Mailing Address - Zip Code:85326-8723
Mailing Address - Country:US
Mailing Address - Phone:602-565-2703
Mailing Address - Fax:
Practice Address - Street 1:1300 N MILLER RD
Practice Address - Street 2:
Practice Address - City:BUCKEYE
Practice Address - State:AZ
Practice Address - Zip Code:85326-1000
Practice Address - Country:US
Practice Address - Phone:602-565-2703
Practice Address - Fax:928-286-5158
Is Sole Proprietor?:No
Enumeration Date:2009-12-02
Last Update Date:2019-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLMSW-119121041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical