DR. MIKE GROSS, LLC (NPI# 1386122489) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386122489 |
| Entity Type | Organization |
| Organization Name | DR. MIKE GROSS, LLC |
| Other Organization Name | TRISTATE SPORTPSYCH |
| Practice Address |
27 Clyde Rd Ste 102 Somerset NJ 08873-5039 |
| Practice Telephone | 9089130637 |
| Mailing Telephone | 9089130637 |
| Enumeration Date | 2018-07-31 |
| Last Update Date | 2018-07-31 |
| Authorized Official Name | DR. MIKE GROSS (LICENSED PSYCHOLOGIST) |
| Authorized Official Telephone | 9089130637 |
| Authorized Official Credential | PSYD, LPC, CMPC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103TB0200X |
Psychologist Specialization: Cognitive & Behavioral |
35SI00577700 | NJ | Behavioral Health & Social Service Providers |
| N | 103TC0700X |
Psychologist Specialization: Clinical |
35SI00577700 | NJ | Behavioral Health & Social Service Providers |
| Y | 103TE1100X |
Psychologist Specialization: Exercise & Sports |
35SI00577700 | NJ | Behavioral Health & Social Service Providers |
| Other Name | Type Code |
|---|---|
| TriState SportPsych | Doing Business As Name - Organization |
| Street Address |
27 CLYDE RD STE 102 |
| City | SOMERSET |
| State | NJ |
| Zip Code | 08873-5039 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932472990 | Michael Brian Gross | Counselor | 27 Clyde Rd Ste 102, Somerset, NJ 08873 | 2012-02-21 |
| 1710471875 | New Jersey Neuropsychology, LLC | Clinic/Center | 27 Clyde Rd Ste 102, Somerset, NJ 08873-5039 | 2018-06-21 |
| 1770076580 | John Bradley Fechter | Clinical Neuropsychologist | 27 Clyde Rd Ste 102, Somerset, NJ 08873 | 2018-06-07 |
| 1588055156 | Jeanne Elizabeth Girardy | Family Medicine | 27 Clyde Rd Ste 102, Somerset, NJ 08873-5039 | 2015-02-18 |
| 1588060982 | Sandi Fields | Social Worker | 27 Clyde Rd Ste 102, Somerset, NJ 08873-5039 | 2014-11-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982204939 | Mark Anthony Diehl | Physical Medicine & Rehabilitation | 1553 State Highway 27, Suite 3100, Somerset, NJ 08873 | 2020-10-29 |
| 1447859483 | Somerset Senior Care, LLC | Assisted Living Facility | 1870 Easton Avenue, Somerset, NJ 08873 | 2020-10-21 |
| 1902415748 | Theranorth Services, LLC | Day Training, Developmentally Disabled Services | 1075 Easton Ave., Tower 2 #4, Somerset, NJ 08873 | 2020-07-28 |
| 1710461157 | Rachnaben Tripathi | Clinic/Center | New Life Adult Daycare, 727 Franklin Blvd., Suite 6, Somerset, NJ 08873 | 2018-09-21 |
| 1487149431 | Dungarvin New Jersey, LLC-rachel | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 215 Rachel Court, Somerset, NJ 08873 | 2018-06-22 |
| 1881192714 | Maggy Lawrence | Nurse Practitioner | 1553 Nj-27, Somerset, NJ 08873 | 2018-01-25 |
| 1548779333 | Alternatives, Inc. | Community/Behavioral Health | 10 Vince Rd, Somerset, NJ 08873 | 2017-09-25 |
| 1659893014 | John Okoye | Case Manager/Care Coordinator | 873 Hamilton Street Unit A, Somerset, NJ 08873 | 2017-07-07 |
| 1245766252 | Salma Khan | Dentist | 1543 Nj 27, Somerset, NJ 08873 | 2017-05-11 |
| 1861927238 | The Devereux Foundation | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1jfk Boulevard, Unit 1f, Somerset, NJ 08873 | 2017-04-24 |
| Find all providers in zip 08873 | ||||
| Taxonomy Code | 103TE1100X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Exercise & Sports |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518593169 | Gianna Lisa Jacobelli | Psychologist | 626 Adams St, Hoboken, NJ 07030-2004 | 2020-03-16 |
| 1912327545 | Abrams Psychological Services | Psychologist | 620 Tinton Ave, Building. A, Suite 203, Tinton Falls, NJ 07724-3260 | 2014-04-22 |
| 1891130431 | Preston Saeed Brown Sr. | Psychologist | 1301 Hancock Dr Apt 1, Barrington, NJ 08007-1624 | 2013-05-09 |
Please comment or provide details below to improve the information on DR. MIKE GROSS, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.