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Individual
JUSTEN JON GROSS
Active
Individual
JUSTEN JON GROSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
S.0030847
OH
1041C0700X
Clinical Social Worker
Primary
C007525
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6007998
—
NC
Enumeration date
12/03/2011
Last updated
11/18/2025
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