Teresa Gross, LPC, SACIT

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

6296-125 Issued in WI

Practice address

1000 N Lynndale Dr
Suite C
Appleton, WI 54914-3056

Phone

(920) 735-9010

Fax

(920) 735-9050

NPI assigned

Nov 15, 2016

Sex

Female

Sole proprietor

No

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

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• A Village LLC

  • Mental Health Counselor
  • Appleton, WI
  • NPI 1699233270

  Addiction (Substance Use Disorder)

  NPD Authorized official
• Options Treatment Programs, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Appleton, WI
  • NPI 1194945378
  NPD (past)

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

{
    "created_epoch": "1479168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479859200000",
    "number": "1508308099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 N LYNNDALE DR",
            "address_2": "SUITE C",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549143056",
            "telephone_number": "920-735-9010",
            "fax_number": "920-735-9050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 N LYNNDALE DR",
            "address_2": "SUITE C",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549143056",
            "telephone_number": "920-735-9010",
            "fax_number": "920-735-9050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSS",
        "first_name": "TERESA",
        "credential": "LPC, SACIT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-15",
        "last_updated": "2016-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "17985-130",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "6296-125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary E Gritton, PA
• Cynthia A Groboski, LPC
• Angelica M Gronke, RD CD
• Joshua Groom, CSAC
• Jenifer L Grooms, CRNP, APRN
• Tierney Shannon Grosskopf, M.D.
• Thomas P. Grotenhuis, DDS
• Lisa M Grothe, APNP
• Aaron R Gruber, O.D.
• Michelle L Gruenstern, RN

• All providers in Appleton, WI
• Mental Health Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2016; 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.