Provider Demographics
NPI:1174944862
Name:GROSSO, SHARON (LCSW)
Entity type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:
Last Name:GROSSO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 ASPEN CT
Mailing Address - Street 2:
Mailing Address - City:BORDENTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08505-4240
Mailing Address - Country:US
Mailing Address - Phone:973-885-4007
Mailing Address - Fax:
Practice Address - Street 1:24 ASPEN CT
Practice Address - Street 2:
Practice Address - City:BORDENTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08505-4240
Practice Address - Country:US
Practice Address - Phone:973-885-4007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-23
Last Update Date:2014-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC05575300101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health