Provider Demographics
NPI:1518239680
Name:GROSS, ANGELA D (LPC)
Entity type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:D
Last Name:GROSS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:7345 COURAGE WAY
Mailing Address - Street 2:STE 101
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-1555
Mailing Address - Country:US
Mailing Address - Phone:423-454-4866
Mailing Address - Fax:423-602-9796
Practice Address - Street 1:7345 COURAGE WAY
Practice Address - Street 2:STE 101
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-1555
Practice Address - Country:US
Practice Address - Phone:423-454-4866
Practice Address - Fax:423-602-9796
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-03
Last Update Date:2016-04-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TNLPC1587101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional