Provider Demographics
NPI:1295337327
Name:BROWN GROSS, SHARON (COUNSELOR)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:BROWN GROSS
Suffix:
Gender:F
Credentials:COUNSELOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1727 AMSTERDAM AVENUE
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10031
Mailing Address - Country:US
Mailing Address - Phone:646-683-4763
Mailing Address - Fax:
Practice Address - Street 1:1727 AMSTERDAM AVENUE
Practice Address - Street 2:3RD FLOOR - ADDICTION SERVICES
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10031-1003
Practice Address - Country:US
Practice Address - Phone:646-683-4763
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-13
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY27956101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)