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Individual

MR. SEAN MICHAEL GROSSE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CADC-R, CRM, QMHA-R

Contact information

Practice address
1966 GARDEN AVE, EUGENE, OR 97403-1933
(541) 246-3532
Mailing address
1966 GARDEN AVE, EUGENE, OR 97403-1933
(541) 246-3432

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
T-23-2633
OR
101YM0800X
Mental Health Counselor
24-QMHA-R-6036
OR
175T00000X
Peer Specialist
23-CRM-1965

Other

Enumeration date
01/18/2024
Last updated
10/14/2024
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