Jeffrey William Gross, SAC-IT

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

20388-130 Issued in WI

Practice address

540 N Broadway RM 142
Green Bay, WI 54303-3404

Phone

(920) 246-5990

NPI assigned

Sep 14, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

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.

• Restoring Hope Ministries Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • De Pere, WI
  • NPI 1194514778

  Addiction (Substance Use Disorder)

  NPD Authorized official

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

{
    "created_epoch": "1694649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758326400000",
    "number": "1720865488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 N BROADWAY RM 142",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543033404",
            "telephone_number": "920-246-5990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 N BROADWAY RM 142",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543033404",
            "telephone_number": "920-246-5990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSS",
        "first_name": "JEFFREY",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "SAC-IT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-09-14",
        "last_updated": "2025-09-20",
        "certification_date": "2025-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "20388-130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael J Grogan, M.D., J.D.
• Colleen Michelle Gromowski, MS,LMFT
• Alexis Groop, P.T.A.
• David Allen Groop, PT
• Faith Gross
• David L Groteluschen, M.D.
• Jeramiah Gruendemann, PSYD
• Staci Marie Gruenke, MS, LAT, CSCS
• Michael J Gruesen, D.O.
• Jeffrey Alan Gruse, RN

• Addiction (Substance Use Disorder) Counselor in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Addiction (Substance Use Disorder) Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2025; 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.