Organization
DR. MIKE GROSS, LLC
Active
Other names
TriState SportPsych
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MIKE GROSS PSYD, LPC, CMPC (LICENSED PSYCHOLOGIST)
(908) 913-0637
Entity
Organization
Contact information
Practice address
30 CHATHAM ROAD #803, SHORT HILLS, NJ 07078-0707
(908) 913-0637
Mailing address
30 CHATHAM ROAD #803, SHORT HILLS, NJ 07078-5039
(908) 913-0637
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
35SI00577700
NJ
103TC0700X
Clinical Psychologist
35SI00577700
NJ
103TE1100X
Exercise & Sports Psychologist
Primary
35SI00577700
NJ
Other
Enumeration date
07/31/2018
Last updated
08/26/2021
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