Individual
JOHANNA LIV GROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1112 NODAK DR S, FARGO, ND 58103-2333
(701) 232-6224
Mailing address
1112 NODAK DR S, FARGO, ND 58103-2333
(701) 232-6224
(701) 232-4687
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6625
ND
1041C0700X
Clinical Social Worker
Primary
6625
ND
Other
Enumeration date
11/09/2023
Last updated
06/08/2026
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