Michael Brian Gross, PSYD, LPC, CMPC

Primary specialty

Exercise & Sports PsychologistTaxonomy code 103TE1100X

License

35SI00577700 Issued in NJ

Practice address

30 Chatham Road #803
Short Hills, NJ 07078-0707

Phone

(908) 913-0637

NPI assigned

Feb 21, 2012

Last updated

Aug 25, 2021By 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 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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

• Dr. Mike Gross, LLC

  dba TriState SportPsych

  • Exercise & Sports Psychologist
  • Short Hills, NJ
  • NPI 1386122489

  Cognitive & Behavioral

  NPD

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

{
    "created_epoch": "1329782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629849600000",
    "number": "1932472990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 CHATHAM ROAD #803",
            "city": "SHORT HILLS",
            "state": "NJ",
            "postal_code": "070785039",
            "telephone_number": "908-913-0637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 CHATHAM ROAD #803",
            "city": "SHORT HILLS",
            "state": "NJ",
            "postal_code": "070780707",
            "telephone_number": "908-913-0637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSS",
        "first_name": "MICHAEL",
        "middle_name": "BRIAN",
        "name_prefix": "Dr.",
        "credential": "PSYD, LPC, CMPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-02-21",
        "last_updated": "2021-08-25",
        "certification_date": "2021-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NJ",
            "license": "37PC00442900",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NJ",
            "license": "35SI00577700",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "NJ",
            "license": "35SI00577700",
            "primary": false
        },
        {
            "code": "103TE1100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Exercise & Sports",
            "state": "NJ",
            "license": "35SI00577700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Good Life Center for Mental Health
• Good Talk Therapy, LLC
• Debra L Goodman, LCSW
• Robert Grabelsky, PH.D.
• Gabrielle Taylor Gross, LCSW, LCSW-C
• Growth Wellness LLC (Growth Wellness)
• Allison Pauline Gurey Wasserstein, M.D.
• Halperin Chiropractic Associates Limited
• Sean Han
• Jeffrey A. Hankinson, DMD

• Psychologist in Short Hills, NJ
• Providers in Short Hills, NJ by specialty
• Psychologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2021; 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.