Colette Alexis Grosso, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CW18469 Issued in PA

Practice address

1518 Walnut St
Suite 900
Philadelphia, PA 19102

Phone

(267) 712-9622

Fax

(486) 352-3659

NPI assigned

Feb 22, 2016

Sex

Female

Sole proprietor

No

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

Opted out of Medicare

Yes, effective Jan 29, 2024 through Jan 29, 2028

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.

• Equilibria Mental Health Services

  • Community/Behavioral Health Agency
  • Philadelphia, PA
  • NPI 1225792872
  NPD (past)
• Equilibria Psychological and Consultation Services, LLC

  • Clinical Psychologist
  • Philadelphia, PA
  • NPI 1356454045
  NPD (past)

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

{
    "created_epoch": "1456099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676851200000",
    "number": "1851750590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1518 WALNUT ST",
            "address_2": "SUITE 900",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19102",
            "telephone_number": "267-712-9622",
            "fax_number": "486-352-3659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1518 WALNUT ST",
            "address_2": "SUITE 900",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19102",
            "telephone_number": "267-712-9622",
            "fax_number": "486-352-3659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSSO",
        "first_name": "COLETTE",
        "middle_name": "ALEXIS",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-22",
        "last_updated": "2023-02-20",
        "certification_date": "2023-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW18469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lawrence B Grossman, MD
• Nicole Grossman
• Peter Grossman, M.D.
• Shoshana Grossman, M.D.
• Liron Grossmann
• Dolores A. Grosso, CRNP
• Joseph Grosso
• Kristen Grotheer, MD
• Paul Grous, P.T.
• Charles E Grove, PHD, MSW

• Clinical Social Worker in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Clinical Social Worker in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.