Wardell Gross Jr., RC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

420 Lakehurst Rd
Browns Mills, NJ 08015-6054

Phone

(609) 893-3450

Fax

(609) 893-3442

NPI assigned

Mar 29, 2019

Last updated

Mar 29, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1553817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553817600000",
    "number": "1205397312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "770 WOODLANE RD",
            "city": "WESTAMPTON",
            "state": "NJ",
            "postal_code": "080603804",
            "telephone_number": "609-893-3450",
            "fax_number": "609-893-3442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 LAKEHURST RD",
            "city": "BROWNS MILLS",
            "state": "NJ",
            "postal_code": "080156054",
            "telephone_number": "609-893-3450",
            "fax_number": "609-893-3442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSS",
        "first_name": "WARDELL",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "RC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-03-29",
        "last_updated": "2019-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karendeep Kaur Gill, FNP-C
• Jennifer J Gogliuzza, RPH
• Terry Goodwin, LPN
• Eileen Mirasol Gorsh, APN
• Heather Grametbauer, LMT, MLD-C
• Jennifer Guardino
• Sandra Janet Hammond, RN
• Amy L. Harvey O'Keeffe, M.D.
• Alexie He, RPH
• Thomas A Hebert

• Mental Health Counselor in Browns Mills, NJ
• Providers in Browns Mills, NJ by specialty
• Mental Health Counselor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.