Provider Demographics
NPI:1972368645
Name:GROSS, BARUCH LEIB (LMSW)
Entity type:Individual
Prefix:
First Name:BARUCH
Middle Name:LEIB
Last Name:GROSS
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6314 BENHURST RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21209-3825
Mailing Address - Country:US
Mailing Address - Phone:443-465-4068
Mailing Address - Fax:
Practice Address - Street 1:3655A OLD COURT RD STE 1
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21208-3959
Practice Address - Country:US
Practice Address - Phone:410-630-9064
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-20
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker