Provider Demographics
NPI:1255773214
Name:GROHS, MELISSA (MA, LPCC)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:GROHS
Suffix:
Gender:F
Credentials:MA, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 PARK ST
Mailing Address - Street 2:SUITE 105
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501-6295
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:450 PARK ST
Practice Address - Street 2:SUITE 105
Practice Address - City:ALAMEDA
Practice Address - State:CA
Practice Address - Zip Code:94501-6295
Practice Address - Country:US
Practice Address - Phone:510-863-4478
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-19
Last Update Date:2016-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101YP2500X
IL180008736101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional